To explore the association between socioeconomic factors and acculturation with cancer screening methods, we analyzed data from the Hispanic Established Population for the Epidemiologic Study of the Elderly, on 1,272 women aged 75 and older residing in the United States in 2004-2005. We found that lower Pap smear or mammography uses were associated with older age, lower education, and having public health insurance compared with private. Other factors associated with mammography use were depressive symptoms, cognition, and functional limitations. In sum, socioeconomic factors and health insurance coverage, but not acculturation, determine cancer screening utilization in very old Mexican American women.