The purpose of this study was to examine the relationships among acculturation, cultural adjustment problems, and psychological distress among Hmong Americans living in the Midwestern portion of the United States. A demographic questionnaire, the Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA; Suinn, Rickard-Figueroa, Lew & Vilgil, 1987), the Cultural Adjustment Difficulties Checklist (CADC; Sodowsky & Lai, 1997), and the Psychological Distress Questionnaire (PDQ) were used for this study. A sample of 245 Hmong Americans, males and females, ages 18 and older were recruited to participate in this study. All participants were recruited from major non-profit sport tournament events, community organizations, businesses, and churches in Midwestern cities. It was hypothesized that: (1) Higher level of acculturation will be related to a lower level of cultural adjustment difficulties. (2) Higher level of cultural adjustment difficulties will be related to higher degree of psychological distress. (3) Higher level of acculturation will be related to lower degree of psychological distress. (4) Level of cultural adjustment difficulties will mediate the relationship between acculturation and psychological distress. Results of the study revealed that Pearson correlations coefficient of acculturation was not related to cultural adjustment difficulties and psychological distress among Hmong Americans. Therefore, the hypotheses 1 and 3 were not supported. However, cultural adjustment difficulties were related to psychological distress among Hmong Americans. Second, the results of multiple regression model shows that conditions that outlined by Baron and Kenny (1986) to establish mediation were not held because first, the predictor variable is not significantly associated with the criterion variable. Second, the predictor variable is not significantly associated with the mediating variable. Third, the mediating variable is significantly associated with the criterion variable but the impact of predictor on criterion is not significantly associated with the criterion variable after controlling for mediating variable. Therefore, hypothesis 3 was also not supported because mediation has not been established. Finally, in terms of the post hoc analysis of the variables, the results of Pearson correlations coefficient show that acculturation was significantly related to place of birth, education, and religion. Cultural adjustment difficulty was significantly related to psychological distress, education, and income. Interpretation of results and implications for future research are discussed.