This study examined the relationship between symptoms of psychiatric morbidity and health problems among a nationally representative, cross-sectional sample of 2107 black adults from the National Survey of Black Americans. Subjects experiencing a high level of psychiatric symptomatology had a significantly higher number of health problems and reported a lower level of satisfaction with their overall health than blacks with low levels of psychiatric symptoms or those who never experienced emotional problems. Individuals with the highest level of psychiatric symptomatology were more likely to have been physician-diagnosed as having ulcers, hypertension, diabetes, kidney problems, nervous-emotional problems, and circulatory system difficulties. These relationships persisted after controlling for age, gender, socioeconomic factors, and traditional risk factors for health problems, such as smoking and alcohol use. Although generally consistent with previous research on predominantly white samples, these specific findings underscore the complexities involved in drawing inferences from associations between psychiatric symptomatology and health problems observed in cross-sectional surveys. Prospective psychiatric epidemiologic studies, utilizing better measures of psychological distress and objective health outcome measures, are needed to clarify the relationship between psychiatric difficulties and health problems among black Americans.