Objective: To describe the reproductive and mental health of American Indian and Alaska Native (AI/AN) women -an understudied population.Methods: Data from the 2004 Behavioral Risk Factor Surveillance System survey were analyzed to determine (1) the prevalence of female sterilization among a nationally representative sample of reproductive age AI/AN women and (2) the association of female sterilization and poor mental health among AI/AN women compared with non-Hispanic White, non-Hispanic Black, and Hispanic women.Results: Nearly 25% of AI/AN women reported female sterilization, a prevalence higher than the comparison racial/ethnic groups (P<0.005). Adjusting for socio-demographic characteristics, AI/AN women reporting female sterilization had nearly 2.5 times the odds of poor mental health compared to AI/AN women not reporting female sterilization (P=0.001). The same magnitude of relationship between female sterilization and poor mental health was not found for non-Hispanic White, non-Hispanic Black, and Hispanic women.Conclusions: AI/AN women reporting female sterilization have significantly higher odds of reporting poor mental health. Common cultural experiences, such as a shared ancestral history of forced sterilizations, may be relevant, and could be considered when providing health and mental health services to AI/AN women.