The objectives of the study were to assess and compare the social characteristics, prevalence of disease, health needs, dependency and use of health services by elderly people in the different ethnic groups living in an inner city. A prevalence study was conducted using a questionnaire administered to people aged 65 years and over living at home, selected from the registers of inner city general practices in West Birmingham. Contact was made with 736 individuals from the original sample of 1,450 names, and completed questionnaires were obtained from 669 individuals (297 men, 372 women). Respondents were divided by place of birth into four groups: UK, Asia, West Indies, and 'Other'. Outcome measures were demographic data, language, household composition, prevalence of disease and health problems, help with activities of daily living, and contact with and knowledge of community health services. We found that those born in the UK were likely to be older, female, unmarried and living alone. In the Asian group, only 15% spoke English and 59% lived in a household with more than three other people compared with 4% in both the UK and West Indian groups. Hypertension was more common in West Indians, arthritis in Asians and diabetes mellitus more common in both groups than in the UK group. Asians were more likely to complain of poor vision. The level of dependency was similar in all groups despite age differences. Contact with community health services was low among Asians who also had a low awareness of the availability of these services. The conclusions from the study were that the average age of elderly individuals in ethnic minority groups is less than that of the indigenous population, making direct comparison difficult. Nevertheless, they have a higher prevalence of age-related disease and a similar level of dependency. They are less well served by, and have little knowledge of the existence of, community health services. For older Asians, difficulty in communicating with English-speaking health personnel is a major barrier to effective health care. Access to health care by older people from ethnic minorities needs to be improved, and services developed in a more culturally sensitive manner.