Objective: The objective of this study is to determine racial and ethnic variations in specialty care utilization based on (a) perceived health status and (b) chronic disease status. Methods: Variations in specialty care utilization, by perceived health and chronic disease status, were examined using the Commonwealth Fund Health Care Quality Survey ( n = 6722). Multivariate logistic regression and chi-squared analyses were used. Results: Hypertension was the most common chronic disease (25 per cent). Respondents with negative perceived health and minorities were less likely to report specialty care. Non-English language and foreign-born status were predictors of low specialty care use. Conclusions: Efforts to improve outcomes should be tailored and provided in a culturally and linguistically appropriate manner. Bilingual efforts to promote specialty care and methods to eliminate patient and system level barriers are needed.