Many studies find racial differences in prayer and religious practices, but few reports examine factors that help explain the effects of Hispanic ethnicity or African American race. A national survey conducted in 2002 collected data on 10 non-religious spiritual practices as well as on prayer for health reasons in 22,929 adults aged 18 years and over. We found marked racial and ethnic differences in the use of prayer and other spiritual practices for health reasons. Greater proportions of African Americans and Hispanic Americans than European Americans reported prayer for health reasons. Sociodemographic variables and health status could not explain these differences. Further, among those who reported prayer, African Americans were more likely than European Americans to report being prayed for by others. However, African American women and Hispanic women and men were significantly less likely than European Americans to use other spiritual practices such as meditation and Tai Chi. Surprisingly African American men were just as likely to report these practices as European American men. Sociodemographic variables and health status could not explain these differences.