Background: Ethnic disparities in healthcare quality have been documented, but knowledge of differences in cardiovascular risk factor prevalence, awareness, treatment, and control between Mexican Americans and non-Hispanic whites remains incomplete. Methods: Cross-sectional analysis in 2005 of nationally representative data collected from 2256 Mexican-American and 4624 non-Hispanic white adults aged 20 years and over who participated in the 1999-2002 National Health and Nutrition Examination Survey. Results: Type 2 diabetes is significantly more prevalent in Mexican Americans (13% age and gender adjusted) than in non-Hispanic whites (8%); however, Mexican Americans are more likely to be both diagnosed (77% vs 65%) and treated (63% vs 47%). There is no significant difference in the adjusted prevalence of hypertension, at 28% for non-Hispanic whites compared to 26% for Mexican Americans. Mexican Americans have a slightly lower adjusted prevalence of dyslipidemia, at 31% versus 35%. Awareness of hypertension and dyslipidemia are significantly lower in Mexican Americans (57% vs 71% for hypertension, and 33% vs 56% for dyslipidemia). Treatment rates for hypertension and dyslipidemia are also significantly lower in Mexican Americans (42% vs 61% for hypertension; 14% vs 30% for dyslipidemia). Multivariate logistic regression controlling for age, gender, education, and access to care indicate that Mexican Americans are significantly more likely than non-Hispanic whites to be aware and treated for their diabetes, but significantly less likely to be aware and treated for their hypertension or dyslipidemia. Conclusions: The significantly higher prevalence of diabetes in Mexican Americans, in contrast to hypertension and dyslipidemia, may sensitize healthcare providers to its detection and treatment. Communicating the importance of hypertension and dyslipidemia is essential for eliminating disparities.