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We aimed to examine the mediating role of accelerated aging in the association between diet quality and CVD incidence and mortality. Data were obtained from the UK Biobank cohort. Diet quality was evaluated using four established indices: the Healthy Eating Index-2020, the Alternative Healthy Eating Index, the Dietary Approaches to Stop Hypertension index, and the Mediterranean Diet Score. Accelerated aging was assessed by the Phenotypic Age Acceleration and Biological Age Acceleration. Outcomes included incident CVD and CVD mortality. Multivariable linear regression model, Cox proportional hazards model, and formal mediation analysis were performed. Subgroup analyses were conducted according to sex, age, and CVD subtypes. This analysis comprised 52,718 UK Biobank participants who were followed for a mean of 12 years. Accelerated aging significantly mediated the associations between diet quality and both incident CVD and CVD mortality across the four indices. The proportion mediated ranged from 21.81 to 40.84% for incident CVD and from 16.67 to 35.87% for CVD mortality. Our study indicates that accelerated biological aging may serve as a potential intermediate pathway linking diet quality to CVD. These findings suggest that aging-related physiological dysregulation may be a potential target for future dietary intervention research. Incorporating population stratification by sex, age, and disease subtype is essential to develop more precise and effective dietary guidelines to improve cardiovascular health.