Higher adherence to a Mediterranean-type diet is linked to lower risk of mortality, cardiovascular disease and Alzheimer's disease while its association with disability has never been assessed. The aim of the study was to investigate the relation between adherence to a Mediterranean diet (MeDi) and disability in activities of daily living. The study sample consisted of 1,410 individuals from Bordeaux, France, included in 2001-2002 in the Three-City Study and re-examined at least once over 5 years. Adherence to a MeDi (scored as 0-9) was computed from a food frequency questionnaire and 24H recall. Disability in Basic and Instrumental ADL (B-IADL) was evaluated on the Lawton-Brody and Katz scales. Statistical analyses were stratified by gender and adjusted for potential confounders. No association between MeDi adherence and baseline disability in B-IADL was highlighted in men or in women in multivariate models. Risk of onset of disability in B-IADL over time was not significantly associated with MeDi adherence in men. In women, MeDi adherence was inversely associated with the risk of incident disability in B-IADL (HR = 0.90, 95% Confidence Interval 0.82-0.98 for 1 point of the score). Women with the highest MeDi adherence (score 6-8) had a 50% (22-68%) relative risk reduction of incident disability in B-IADL over time than women in the lowest MeDi category (score 0-3). In addition to its well-documented beneficial effects on health, adherence to a Mediterranean-type diet could contribute to slow down the disablement process in women.