Factors related to American Indian (AI) high school students' self-rated health were examined. Self rated health was measured as a single-item with a four-point response option ranging from poor to excellent health. Of the 574 participants, 19% reported "fair" or "poor" health, a percentage more than twice that for U.S. high school students in general. Gender (related to family finances), school achievement, social competence, and cannabis use were significantly associated with the AI teens' self-rated health. In comparative examination, factors associated with AI teens' health ratings were found to be similar and dissimilar to ratings of other teens in important ways.