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Rationale. Childhood asthma is a major public health problem, with mainland and island Puerto Rican children having the highest asthma rates of any ethnic group in the United States. Objectives. To examine the relationship between maternal mental health problems, prenatal smoking, and risk of asthma among children in Puerto Rico and the Bronx, New York. Methods. A cross-sectional community-based study was conducted in the South Bronx in New York City and the San Juan Standard Metropolitan Area in Puerto Rico. Participants were Puerto Rican children 5 to 13 years of age and their adult caretakers with probability samples of children 5 to 13 years of age and their caregivers drawn at two sites: the South Bronx in New York City (n = 1,135) and San Juan and Caguas, Puerto Rico (n = 1,351). Measurements. Self-reported maternal mental health, prenatal smoking, and rates of childhood asthma. Results. Maternal mental health problems were associated with significantly higher levels of prenatal smoking, compared with that among women without mental health problems (p < 0.0001). Both maternal mental health problems and prenatal smoking appear to make a contribution to increased odds of asthma among youth. After adjusting for prenatal smoking, the relationship between maternal mental health problems and childhood asthma was no longer statistically significant. Conclusions. Previous research suggests children of Puerto Rican descent are especially vulnerable to asthma. Our results suggest that maternal mental health problems and prenatal smoking are both associated with increased odds of asthma among Puerto Rican youth and that prenatal smoking may partly explain the observed relationship between maternal psychopathology and childhood asthma. Future longitudinal and geographically diverse epidemiological studies may help to identify the role of both maternal mental health problems and prenatal smoking in the health disparities in childhood asthma. [ABSTRACT FROM AUTHOR]