Background <p>Studies reporting maternal morbidities and adverse infant outcomes group Hispanics together without considering the implications of racial identity, particularly among Black Hispanics in the United States.</p> Objective <p>This study aims to examine maternal morbidity and adverse infant birth outcomes across racially and ethnically diverse groups in Florida (from 2004–2022), with particular attention to the heterogeneity within the Hispanic population.</p> Methods <p>We conducted a retrospective secondary analysis of Florida birth certificate data from 2004 to 2022 (N = 3,364,973), examining maternal morbidity (hypertensive disorders in pregnancy, gestational diabetes) and adverse infant outcomes (preterm birth, small or large for gestational age). Outcomes were stratified by race and ethnicity. Logistic regression models were employed to estimate crude and adjusted odds ratios while controlling for key sociodemographic covariates.</p> Results <p>Black Hispanic mothers had higher odds of hypertensive disorders in pregnancy, but no significant difference in gestational diabetes after considering the independent impact of race and ethnicity. Their infants had lower odds of preterm birth and small-for-gestational-age, and higher odds of large-for-gestational-age after considering the independent impact of race and ethnicity. Compared to other groups, Black Hispanics had the lowest rates of private insurance, educational attainment, and prenatal care adequacy, highlighting sociodemographic disparities alongside clinical outcomes.</p> Conclusion <p>Our findings highlight nuanced disparities in maternal and infant outcomes for Black Hispanics. Further investigation is essential to understand why maternal health outcomes for Black Hispanics align more closely with their Black counterparts, while infant outcomes diverge, emphasizing the need for disaggregated analyses within the Hispanic population.</p>