To examine associations of health belief and health literacy with Pap smear practice among Asian immigrant women in South Korea. This study used a descriptive, cross-sectional study design. A survey was conducted among 196 migrant women who were married to South Korean men, using a questionnaire translated into English, Chinese, Vietnamese, and Korean. Trained research assistants read the questionnaire and the participants gave their answers. The most common birthplace of the immigrant women was Vietnam (43.0%), followed by China (12.2%) and the Philippines (5.6%). Of the participants, 76.5% answered that they had never had a Pap smear test. Multiple logistic regression analysis revealed that age and functional health literacy were associated with Pap smear practice among Asian immigrant women. With a one-year increase in participants' age, Pap smear practice increased 1.15 times (OR = 1.15, 95% CI: 1.07, 1.23). Furthermore, with a one point increase in functional health literacy, Pap smear practice increased 1.18 times (OR = 1.18, 95% CI: 1.02, 1.37). Results suggest that more information about Pap smear tests should be provided to young immigrant women. Health providers should be made aware that Pap smear practice among young immigrant women might be infrequent and should actively recommend that they receive the tests. To improve Pap smear practice among immigrant women, it is also crucial for educational strategies to include functional health literacy. Nurses could play an important role in explaining and recommending the Pap smear test through communication with immigrant women. Copyright © 2019 Elsevier Ltd. All rights reserved.