The purpose of this study was to assess risk factors associated with a history of hysterectomy among Mexican-American women living in the United States Southwest. Mexican-American women ages 20–74 at time of interview were defined as a subpopulation among adults in the Hispanic Health and Nutrition Examination Survey (HHANES), 1982–1984. Language preference, reproductive history, level of education, poverty status, generation of immigration, marital status, and insurance coverage were examined in relation to risk of hysterectomy using weighted tabulation and logistic regression for data resulting from complex survey designs. Heretofore, language preference has not been a variable considered in relation to risk of hysterectomy. In the HHANES, over 60% of women who spoke English most often rather than Spanish reported a history of hysterectomy. Women who had previously been pregnant were almost four times as likely (odds ratio 3.972) to have had a hysterectomy compared to women who had never been pregnant. Women who expressed any preference for English were twice as likely (odds ratio 2.050) to have had a hysterectomy than were those who responded that they exclusively preferred Spanish. Age, higher levels of education, and higher economic status also increased the risk of hysterectomy. In contrast, reproductive history, marital status, prior tubal ligation, generation of immigration, and health insurance did not have substantial effects on the risk of hysterectomy. This study suggests that, in the future, the effect of language preference should not be overlooked when considering risk factors for hysterectomy. Am. J. Hum. Biol. 15:38–47, 2003. © 2002 Wiley-Liss, Inc.