Mild cognitive impairment, a common precursor to Alzheimer's disease, disproportionately affects African American individuals compared with their European American peers. The prevalence of this condition among the African American population is magnified by health care disparities and unique cultural aspects. This article describes a culturally tailored intervention for African Americans with mild cognitive impairment (n = 17) based on the Africultural coping model and grounded in cognitive behavioral therapy and motivational interviewing theories. This six-month pilot study describes the rationale and process for creating this novel behavioral health intervention for an in-person and online group, as well as preliminary findings. Despite the small sample size, improved Montreal Cognitive Assessment scores were statistically significant (p , .05). On postsession questionnaires, 94-97% of responses indicated agreement that the group session, intervention, and communication were helpful, relevant, and clear. Participants responded with a slightly lower agreement rate to perceptions of relevance to culture (84%). Overall, results addressing efficacy in this cognitive behavioral therapy/motivational interviewing intervention moved in a positive direction but need further examination with a larger sample size. Additionally, in future research, it will be important to further develop culturally tailored interventions to address the complexities of the African American cultural identity so that interventions are both relevant and effective for African Americans. Clinical Impact StatementPositive findings from this culturally tailored pilot intervention combining cognitive behavioral therapy and motivational interviewing for African Americans with mild cognitive impairment suggest a need for further development of similar programs in primary care.