© Springer International Publishing Switzerland 2016. Compared to Caucasians, African Americans have lower circulating concentrations of 25-hydroxyvitamin D (25(OH)D), the major storage form of vitamin D, leading to the widespread assumption that blacks are at higher risk of vitamin D deficiency. Since low 25(OH)D is associated with adverse cardiovascular and kidney outcomes, this has supported the notion that low 25(OH)D concentrations partly underlie racial disparities in health outcomes, including faster progression of chronic kidney disease (CKD) in blacks vs. whites. However, the finding that blacks maintain better indices of musculoskeletal health than whites throughout their lifespan despite having lower circulating 25(OH)D concentrations suggests that the relationship between vitamin D deficiency and racial health disparities may not be so straight forward. This has been further underscored by epidemiologic studies showing major racial heterogeneity in the association of 25(OH)D with cardiovascular outcomes. When coupled with emerging data showing genetically determined differences in the bioavailability of vitamin D by race, these data suggest that there are important differences in vitamin D metabolism by race which need to inform and perhaps revise our current understanding of the role of vitamin D in racial disparities in CKD outcomes.