Over three million migrant and seasonal farmworkers support a multi-billion dollar U.S. agricultural industry. Yet, many farmworkers work and live in isolated and unsanitary conditions with exposure to agricultural toxins that place them at great health risk. Lack of insurance and service access, poverty, language and culture differences, and low risk perceptions contribute to serious health problems within this workforce. Unfortunately, government funds needed for health promotion and primary care are difficult to obtain due to lack of data-based, documented proof that such need exists. Local health professionals are often keenly aware of the need, but heavy work schedules and inadequate budgets thwart needed documentation efforts. This pilot study was designed to begin obtaining such documentation through assessment of health-related needs among Cherokee County (east Texas) farmworkers. Research questions addressed were: 1) What are the health risks, health-related issues, and characteristics of this population? 2) What do these findings indicate regarding the design of appropriate health risk interventions and health-related services? Qualitative (focus group interviews) and quantitative (face-to-face surveys) data-collection methods were utilized to answer the questions. In four focus group sessions, two representative samples of target population members and two of local health and community service providers were asked to describe common health risk behaviors and contributing factors among Cherokee County migrant and seasonal farmworkers. A modified nominal group process was used in the focus group interviews for professionals to equalize participant input. Emerging response themes, along with reviews of relevant literature and questionnaires used in previous studies, were used to develop and validate a culturally appropriate survey instrument for assessing health risk and health-related needs among migrant and seasonal workers in Texas. Trained bilingual interviewers used the newly created instrument to conduct 200 face-to-face interviews in a convenience sample of the target population residing in Cherokee County. Subscale frequencies and multiple regression analyses were used to identify common health risk factors and their interrelated associations. The focus group and survey results revealed a complex web of health-influencing factors that ranged from broad social barriers (e.g., low income, isolation, mistrust) to more concrete risk behaviors (e.g., drug abuse, lack of prenatal care, poor dietary habits). The researchers gained important insights regarding barriers to use of existing health care services (e.g., mistrust of health personnel and fear of the INS) and culture-specific needs (e.g., language- and culture-specific explanations/materials and social support) related to future health promotion and illness prevention efforts.