Over the past two decades, nutritional and sustainability research has converged and increasingly emphasized the health and environmental benefits associated with diets higher in vegetables, fruits, whole grains, legumes, and nuts and lower in red and processed meat. However, much less is known about the agricultural pesticide footprint of these plant-centered diets. This is partly due to the data and modeling challenges of the question, as different food products are associated with widely different pesticide usage intensities and active ingredient compositions. In this study, we compiled a large dataset covering >60 crops and >350 pesticide types in the US and applied state-of-the-art models to estimate the pesticide usage and freshwater ecotoxicity impacts of the current national diet and four recommended diets, including the widely studied and advocated EAT-Lancet diet, Mediterranean diet, and vegetarian diet. We find that shifting toward these recommended diets, except for the EAT-Lanet diet, would lead to increased pesticide usage and associated ecotoxicity impacts. These elevated impacts, however, could be mitigated through coupling targeted farm-level management practices, such as the adoption of lower-toxicity pesticides, with system-level strategies, such as minimizing food loss and waste (FLW) along the supply chain. Our study suggests that potential sustainable dietary transitions can be further improved by tackling their pesticide footprint through integrated strategies.