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The objective of this study was to describe the use of biomedical services and traditional healing options among a reservation-based sample of American Indians from 2 culturally distinct tribesParticipants were 2595 American Indian adolescents and adults ages 15 to 57 randomly selected to represent 2 tribes living on or near their rural reservations. First, we examined the prevalence and correlates of use of biomedical services and traditional healing for both physical health and psychiatric problems. Second, we developed logistic regression models predicting the independent and combined use of biomedical services and traditional healingThe prevalence of combined and independent use of biomedical services and traditional healing varied by tribe. The prevalence of biomedical service use ranged from 40.9% to 59.1% for physical health problems and 6.4% to 6.8% for psychiatric problems. The prevalence of the use of traditional healing ranged from 8.4% to 22.9% for physical health problems and 3.2% to 7.8% for psychiatric problems. Although combined use of both types of services was common (10.4–22.6% of service users), many used only traditional healing (3.5–40.0%). Correlates of service use included age, educational level, and ethnic identity. For example, use of traditional healing was correlated with higher scores on a scale measuring identification with American Indian cultureBoth biomedical services and traditional healing are important sources of care in American Indian communities, and are used both independently and in combination with one another.