Mexican Americans are at particular risk of contracting tuberculosis. Yet too little is known about perceptions influencing their health. This study investigated gender and acculturation differences in TB-specific Health Belief Model (HBM) constructs, and the applicability of the HBM's traditional configuration to Mexican Americans. Acculturation and gender substantially influenced the findings. Traditional Mexican Americans reported higher perceived susceptibility and seriousness, more barriers, and greater attention to cues regarding TB prevention than Highly Integrated Biculturals. Women reported greater benefits, attention to cues, and intent to engage in TB prevention behaviors than men. Highly Integrated Bicultural men reported less attention to cues and less intent to engage in health behaviors than other groups. The traditional HBM configuration did not fit this sample. Reconfiguration did, however, result in adequate fit. Overall, higher perceived susceptibility, action benefits, attention to media cues, and female gender predicted greater intent to engage in TB health behaviors.