BACKGROUND: The relatively new Chinatown of Brooklyn is medically underserved. A pilot assessment of the health needs of this community was conducted using Rapid Participatory Appraisal. METHODS: In-depth interviews with health professionals and community members plus searches of national, state, and local electronic health databases were conducted taking into account multiple determinants of health. RESULTS: Community organization, sociological factors, services, and policy were all partly responsible for unmet health needs, including the lack of an overall community structure related to health. Health concerns of all kinds were exacerbated by poverty, language barriers, immigration status, culture, and the need for acculturation. Significant health assets were present but were not adequate to address needs. DISCUSSION: While each health concern had its own unique identifiable causes, the interaction of these concerns and the limitations of assets at all levels make solutions difficult.