Background <p>Cancer screening disparities exist among immigrants in the USA, yet the cancer screening behaviors of ethnic Black immigrants remains relatively unknown. The Garifuna, an Afro-Amerindian group, experience structural forces in their homelands and urban settling communities in the USA with little known of their cancer screening behaviors. The purpose of this study is to examine breast cancer screening practices among Garifuna women residing in communities within New York City. The study examined levels of adherence to recommended breast cancer screening guidelines and their association with demographic factors, access to healthcare services, perceptions/barriers, level of acculturation, identity, and breast cancer screening guideline knowledge.</p> Methods <p>This was a cross-sectional survey of immigrant Garifuna women, age 50&#xa0;years and older, residing in New York City. Univariate analysis described the survey study sample and bivariate analysis measured level of association between variables. Logistic regression examined the predictive nature of variables in explaining breast cancer screening adherence to screening guidelines.</p> Results <p>Four hundred and two Garifuna women completed surveys over a 22-month period. Garifuna women had breast cancer screening rates of 82%, higher than the national screening rate of 72%. Longer length of time in the USA, access to healthcare, and motivation to receive screenings were significant predictors of receiving screening.</p> Conclusions <p>The study identified positive structural forces in the New York City community such as access to healthcare that may explain adherence to recommended breast cancer screening guidelines among immigrant Garifuna women.</p>