The Pacific Islands Families study follows a cohort of 1,398 Pacific infants born in Auckland, New Zealand. This article examines associations between maternal acculturation, measured by an abbreviated version of the General Ethnicity Questionnaire, and selected infant and maternal health risk indicators. Findings reveal that those with strong alignment to Pacific culture had significantly better infant and maternal risk factor outcomes than those with weak cultural alignment. In terms of Berry’s classical acculturation model, separators had the best infant and maternal outcomes; integrators had reasonable infant and maternal outcomes, while assimilators and marginalisors appeared to have the poorest infant and maternal outcomes. These findings suggest that retaining strong cultural links for Pacific immigrants is likely to have positive health benefits.