This study describes the perinatal characteristics of Cambodian refugees in Massachusetts. Data were abstracted from the records of 452 consecutive pregnancies among Cambodian women and 110 low-income Whites receiving obstetrical services at the same clinic and hospital in Lowell, Massachusetts. Pregnancies of Cambodian women were marked by a higher proportion of older mothers, grand multiparas, previous adverse birth outcomes, and short interpregnancy intervals. We identified maternal anemia (29.9 percent with hemoglobin less than 110 g/L) and inadequate utilization of prenatal care (32.3 percent with first visit in the 3rd trimester) as possible risk factors for the Cambodians. The prevalence of primary cesarean birth was only 6.3 percent in the Cambodians, compared to 15.6 percent in the comparison group, largely due to the infrequent occurrence of prolonged labor among multiparas. Despite the prominence of several risk factors for adverse birth outcomes in this population, major pregnancy complications were less common and the prevalence of low birthweight (6.4 percent) was close to the state average. Logistic regression analysis of risk factors for low birthweight identified young maternal age and short stature as the strongest factors operative in this community. Many of our findings are consistent with a strong cultural emphasis on managing the size of the baby to avoid a difficult labor and delivery.