Hepatitis B (HBV) infection is a serious health problem among Asian Americans, including Chinese Americans. This study was conducted to measure the perceptions of risk, barriers, and self-efficacy of HBV screening and vaccination in Chinese immigrants. A cross-sectional study was conducted among 429 Chinese Americans in New York City. A pilot-tested questionnaire in Chinese was used to collect information about demographics, acculturation, and health risk perceptions, barriers, and self-efficacy related to screening and vaccination. While 89.3% of participants thought that HBV would harm them if they contracted it, only 32.8% believed that they were at risk for getting it. Participants were more likely to get screened if their physician suggested it, they thought it was a serious disease, would cause harm, and they discussed it with their spouse. Participants were less likely to get screened if they were afraid they had HBV, did not know a screening location, and it was not suggested by their doctor. Participants were less likely to get vaccinated if they did not have time, did not know a screening location, and the physician did not speak their language. Our findings suggest that community-based, culturally appropriate interventions for Chinese Americans and health care providers might increase screening and vaccination rates. (Contains 5 tables.)