Columbia River Basin tribes consume fish at higher levels than the general population, offering nutritional benefits but increasing exposure to contaminants, particularly among children, women of childbearing age, and elders. This study analyzed 1990 CRITFC survey data to assess consumption patterns and associated factors. Fish intake in women and elders was similar to overall participants, with non-fillet parts commonly consumed and baking as the primary cooking method. Higher intake was linked to breastfeeding, non-commercial sourcing, and demographic factors. Diets showed suboptimal fiber and fat intake. Efforts are needed to reduce contaminant exposure while supporting traditional, health-promoting diets.