This cross-cultural comparison study examined the direct and indirect effects (via several cognitive-affective pathways) of insecure attachment on bulimic behaviors and explored cultural similarities and differences in all pathways of the indirect effect model between female university students from the U.S. and Korea. Our findings from the two cultural samples (N = 421 for the Korean sample, N = 271 for the U.S. sample) generally indicated that both insecure attachment variables were associated with bulimia through three-sequential mediational functions of maladaptive perfectionism, lowered self-esteem, and heightened depression. However, the results also highlighted several culturally specific nuances in the indirect effect paths through which adult attachment insecurity affects bulimic behavior (e.g., adult attachment was indirectly associated with bulimia via maladaptive perfectionism and self-esteem only for the U.S. group). Findings are discussed from the perspectives of adult attachment theory, trans-diagnostic theory, and local cultural context. Limitations, future research directions, and counseling implications are presented.