Context: Research shows that soda consumption can lead to higher rates of diabetes, heart disease, strokes, and dementia. It also shows that low-income patients tend to have less knowledge regarding the negative effects of soda. Neighborhood social determinants, such as one’s access to grocery stores and healthy foods, also affect soda consumption. Safety net patients could be at higher risk for negative health outcomes related to increased soda consumption, especially when considering other environmental determinants they face. However, to our knowledge, attitudes towards soda consumption and amounts of consumption among safety net patients has not been studied. Objective: To determine soda consumption and attitudinal differences between safety net patients and patients in mainstream health systems. Study Design: Case/Control with Multinomial Regression. Setting: Primary Care Practices Participants: Primary Care Patients from 11 different practices in the St. Louis Metropolitan Region (N = 361). Intervention/Instrument: Federally Qualified Health Care Center (FQHC) Treatment. Outcome Measure: Questions about soda intake on the Brief Dietary Assessment and Intervention Tool for Health Professionals. Results: FQHC patients consumed less soda (RR = 0.24, 95% CI: 0.21, 0.71; p < 0.05) but also did not think they needed to drink less soda (RR = 0.39, 95% CI: 0.11, 0.53; p < 0.05). Poor health outcomes at the neighborhood level were associated with higher soda consumption (RR = 1.27, 95% CI: 0.99, 1.63; p < 0.1) but also with the belief that one should cut down on soda (RR = 1.22, 95% CI: 1.02, 1.45; p < 0.05). Conclusions: Safety net patients consumed less soda than non-safety net patients, and they were more likely to be content with their current soda consumption. In primary care settings, these findings suggest that providers should gauge water consumption and access, while spending more time explaining negative health outcomes of soda consumption. Given the relatively small sample size and lack of geographic diversity in the sample, these results should be interpreted with caution. Future studies should examine the protective role of negative health outcomes on soda consumption among safety net patients.