Distorted weight perception (DWP), specifically overestimating weight status, is common in adolescents and may lead to eating disorders. The authors examined the role of acculturation proxies as effect modifiers of the relationship between race/ethnicity and DWP in a diverse adolescent population. Analysis of the 2005 California Health Interview Survey showed that of 2955 adolescents with underweight or healthy weight status, 10.6% reported DWP. Latino adolescents had increased odds of DWP compared with white adolescents (adjusted odds ratio [aOR] = 3.02; 95% confidence interval [CI] = 2.00, 4.57). Latinos who spoke English and other language(s) at home (aOR = 3.38; 95% CI = 2.11, 5.41) and Latino (aOR = 5.00; 95% CI = 2.34, 10.72) and Asian (aOR = 3.10, 95% CI = 1.15, 8.35) adolescents who spoke no English at home had increased odds of DWP compared with white, English-only speakers. Latino adolescents had increased odds (aOR = 3.98, 95% CI = 2.45, 6.47) of DWP if neither parent was US born. Assessing acculturation proxies may help identify adolescents at risk of DWP.