There is little research on the oral health status of Chinese-American (CA) children in the U.S. and Asian/Pacific Islanders in general. The purpose of this study was to characterize the dental caries experience of a CA child population in Manhattan Chinatown, New York City. A five-year chart review of 545 initial dental exams of patients aged 2 to 11 was conducted at a community clinic serving an immigrant CA population. DMFT/dft were compared to National Health and Nutrition Examination Survey (NHANES) and analyzed for associations among birthplace, language and untreated tooth decay at recall. Subject mean dft was higher compared to NHANES data both in aggregate and ethnic/race subgroups. Subjects had lower DMFT ccmpared to the national data. Significant difference was found between U.S. and non-U.S.-born mean dft. Asian Pacific Islander Americans include a fast-growing immigrant pediatric population at high risk for tooth decay.