This article examines how facets of family structure and processes are linked to self-rated health and psychological distress in a national sample of Asian Americans. The authors find little support for well-established theories predicting the effects of family structure. Marital status does not affect self-rated health and has limited effects on psychological distress. The only effects of family composition are evident among men and the U.S.-born, where the presence of extended family in the home is related to lower levels of psychological distress. The authors find important gender and nativity differences in the effects of family cohesion, which protect the physical and psychological well-being of women and the U.S.-born but not men or foreign-born individuals. Findings suggest that the effects of family structure and processes on well-being are not universal. Family studies among Asian Americans that do not account for gender and nativity differences may be overlooking underlying complexity. (Contains 5 tables.)