<p>This study investigated the prevalence and potential factors of problem gambling among adults in New Mexico. The state has a diverse population and a well-established gambling industry. The study used data from a survey of 19,202 adults in 2018 and 2019 and found that problem gambling rates (3.1–3.9%) were significantly higher than the national average. The study revealed significant differences in problem gambling prevalence based on sociodemographic factors, with higher rates among males, younger adults, and racial/ethnic minorities, particularly Native American/American Indian respondents. Substance use behaviors and adverse childhood experiences (ACEs) showed strong associations with problem gambling. Logistic regression analyses showed that being male, identifying as Latinx or Native American/American Indian, having lower educational attainment, experiencing housing instability, engaging in substance use, and reporting multiple ACEs significantly increased the odds of problem gambling. A risk score index indicated that the likelihood of problem gambling increased considerably with the accumulation of risk factors. These findings highlight the complex and multifaceted nature of problem gambling in New Mexico, underscoring the need for culturally sensitive interventions. The study offers valuable insights for policymakers, healthcare providers, and community organizations to develop evidence-based strategies to address problem gambling in this specific demographic context.</p>