<p><b>OBJECTIVE: </b>Hispanics/Latinos, the largest immigrant population in the USA, undergo the process of acculturation and have a large burden of heart failure risk. Few studies have examined the association of acculturation on cardiac structure and function.</p><p><b>DESIGN: </b>Cross-sectional.</p><p><b>SETTING: </b>The Echocardiographic Study of Latinos.</p><p><b>PARTICIPANTS: </b>1818 Hispanic adult participants with baseline echocardiographic assessment and acculturation measured by the Short Acculturation Scale, nativity, age at immigration, length of US residence, generational status and language.</p><p><b>PRIMARY AND SECONDARY OUTCOME MEASURES: </b>Echocardiographic assessment of left atrial volume index (LAVI), left ventricular mass index (LVMI), early diastolic transmitral inflow and mitral annular velocities.</p><p><b>RESULTS: </b>The study population was predominantly Spanish-speaking and foreign-born with mean residence in the US of 22.7 years, mean age of 56.4 years; 50% had hypertension, 28% had diabetes and 44% had a body mass index >30 kg/m. Multivariable analyses demonstrated higher LAVI with increasing years of US residence. Foreign-born and first-generation participants had higher E/e' but lower LAVI and e' velocities compared with the second generation. Higher acculturation and income >$20K were associated with higher LVMI, LAVI and E/e' but lower e' velocities. Preferential Spanish-speakers with an income <$20K had a higher E/e'.</p><p><b>CONCLUSIONS: </b>Acculturation was associated with abnormal cardiac structure and function, with some effect modification by socioeconomic status.</p>