A minimal estimate suggests 300,000 Samoans reside outside the Samoan archipelago in the United States, New Zealand, and Australia. Anthropological studies of Samoan migration provide a broader perspective that emphasizes the deep connections among individuals and families residing in and outside the Samoas, and the adaptive nature of these connections. A review of the published socioeconomic, demographic, public health, and medical literatures indicates that Samoans residing outside the Samoas may be at high risk for poor levels of population health because of poverty, low health literacy, and sociocultural influences on health care knowledge, attitude, and access. There is little systematic information on Samoans in the United States and Australia. Based on trends from smaller studies and the national data from New Zealand, we recommend more population-based health research among Samoans. Studies of representative samples will provide more accurate assessments of the spectrum of social and economic characteristics, acculturative processes, the returns and costs of connectedness to the families and villages in the Samoas, and population health characteristics. Studies should emphasize not only the negative costs to health and well-being of migration but the processes of adjustment, accommodation, and adaptation that produce the varieties of ways of life among Samoans outside the Samoas.