In order to better understand variations of health behaviors between US-born and foreign-born elderly Asian Americans (65+) in the United States, the research aims to explore relationships among health outcomes, healthcare utilization, and sociodemographic characteristics. Data from the National Health Interview Survey 1998-2012 is used to construct structural equation models for the US born group and for the foreign born group. The results found that there is a reciprocal relationship between health outcomes and healthcare utilization in both groups. Use of healthcare services can positively affect health outcomes, while better health outcomes reduce the need for healthcare utilization. In addition, some sociodemographic characteristics, such as age, sex, and marital status have a direct effect on health outcomes, but some others, such as education, family size and combined family income, have an indirect effect on health outcomes via healthcare utilization. The region of residency has both direct and indirect effects on health outcomes. Regarding the effects of predictors on health outcomes, US-born elderly Asians usually receive more health advantages from using institutional health services than foreign-born elderly Asians. Practitioners, social gerontologists, and policy makers should be cautious about assuming that there is a positive impact of increased healthcare utilization on health outcomes in elderly Asian Americans.