BACKGROUND: A dose-response and nonlinear association between fruit and vegetable intake and mortality has been reported in Europe and the United States, but little is known about this association in Asia. OBJECTIVES: This study aimed to evaluate the association of fruit and vegetable intake with all-cause, cancer, cardiovascular, and respiratory disease mortality in a Japanese cohort. METHODS: In the Japan Public Health Center-based prospective study, we included 94,658 participants (mean age; 56.4 ± 7.8 years, male; 46.0%) without cancer and cardiovascular disease at baseline. Information on fruit and vegetable intake was collected using a validated food frequency questionnaire. The Cox proportional-hazards model was used to estimate hazard ratios (HR) and 95% confidence intervals (CIs) of each quintile of fruit and vegetable intake, separately, in relation to all-cause and cause-specific mortality using the first quintile as a reference. Nonlinear associations were evaluated using a likelihood ratio test, comparing a linear model with a restricted cubic spline model. RESULTS: During a median of 20.9 follow-up years (interquartile range: 19.6-23.8), 23,687 all-cause deaths were documented. After adjusting for age, sex, and potential confounding factors, fruit and vegetable intake was nonlinearly and significantly associated with lower all-cause mortality, with the fourth and fifth quintiles having comparable HRs (fruit: fourth quintile, HR: 0.91; 95%CI: 0.87, 0.95, fifth quintile, HR: 0.92; 95%CI: 0.88, 0.96; P for nonlinearity < 0.001; vegetable: fourth quintile, HR: 0.92; 95%CI: 0.88, 0.97, fifth quintile, HR: 0.93; 95%CI: 0.89, 0.98; P for nonlinearity = 0.002). Fruit intake was significantly associated with lower cardiovascular mortality (HR in the fifth quintile: 0.91; 95%CI: 0.83, 0.99; P for nonlinearity = 0.01). CONCLUSIONS: In the Japanese population, higher intake of fruits and vegetables was nonlinearly associated with decreased all-cause mortality. These findings may contribute to the establishment of dietary recommendations for enhancing life expectancy in Asia.