Objectives: The primary objective of this study was to analyze the associations between perceived dietary balance and adherence to nutritional recommendations according to the National Nutrition and Health Program (PNNS), using baseline data from the Constances cohort. Methods: The study included 38,129 participants in the Constances cohort. Compliance with the recommendations was measured using a PNNS score constructed based on a qualitative dietary frequency scale, following multiple imputation of partial non-responses. Perception of diet was measured using the question "Do you think your diet is balanced?" Linear regressions were used to model the relationship between dietary perception and the PNNS score, adjusting for the following variables: age, sex, educational attainment, and marital status. Results: A one-point increase in the PNNS score was associated with a 0.23 [0.22–0.24] point increase in perceived balance (rated from 1 to 8). At equal PNNS scores, perceived balance did not differ significantly between men and women. Participants also rated their diet as more balanced when they consumed few prepared meals, fast foods, and snack foods. After imputing partial non-responses, these results did not differ from those obtained for complete cases. Conclusion: The PNNS score, measured using a qualitative frequency questionnaire, was significantly and positively associated with perceived dietary balance. Perceived dietary balance was also positively associated with other dimensions of dietary habits, such as limiting consumption of snack foods and prepared meals. Our results reaffirm the need not only for information campaigns but also for more comprehensive dietary interventions and policies to facilitate the adoption of dietary habits more in line with nutritional recommendations.