The present study explores the impact of acculturation on health status and use of health and community aged care services among elderly Iranian-born immigrants to Australia. Three hundred two Iranian immigrants aged 65 years and over who had lived in the Sydney Metropolitan area for at least six months participated. Data were collected using a written survey instrument, face-to-face interviews, and telephone interviews. Iranian immigrants had higher levels of psychological distress, more limited physical function, greater need for help or assistance with activities of daily living, lower feelings of wellbeing, and were much less likely to use aged care services than the general population of older Australians. Participants who did not speak English at home were more likely to experience psychological distress and had greater limitations in their physical functioning. Elderly Iranians with better English proficiency had lower levels of anxiety and depressive symptoms and reported less need for help and supervision in activities of daily living; they were also more likely to access health care services. Elderly Iranian immigrants experience higher levels of psychological distress and lower levels of physical function than the general population of older Australians; those with limited proficiency in English are at greatest risk. These findings contribute to the enrichment of multicultural policy, social fairness, access, and equity for ethnic aged people.