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BACKGROUND AND OBJECTIVES: The prevalence of sexually transmitted diseases in Hispanic prenatal patients has not been well documented. Studies of disease prevalence in Hispanic patients often are complicated by multiple countries of origin and the combining of foreign-born and U.S.-born Hispanics into a single category. GOAL OF THE STUDY: The purpose of this study was to document the prevalences of sexually transmitted diseases in low-income, pregnant Mexican-American women and to compare the prevalences of those born in the United States with those born in Mexico. We also compared the prevalence of those who recently arrived from Mexico with those who had been in the United States a longer time. STUDY DESIGN: Three-hundred-forty-seven pregnant women attending a clinic for low-income populations were screened for syphilis, gonorrhea, chlamydia, and hepatitis B virus on their first perinatal visit. RESULTS: Thirty-five women (10.1%) were positive for chlamydia, four (1.2%) for gonorrhea, one (0.3%) for syphilis, and none for hepatitis B virus. Women born in Mexico reported fewer past chlamydia and total sexually transmitted disease infections than Mexican-Americans and non-Hispanic whites born in the United States However, the prevalence of chlamydia and total sexually transmitted diseases did not differ by ethnicity, country of birth, or length of time in the United States The only variable correlated with chlamydia infection was the presence of vaginal discharge, but the sensitivity of this symptom was too low to be clinically useful as a means of selective screening. CONCLUSION: Low-income women of Mexican ancestry should be routinely screened for syphilis, gonorrhea, and chlamydia as part of their prenatal care in the United States. The value of hepatitis B virus screening in this population was neither supported nor refuted by this study.