OBJECTIVES: We sought to examine racial and ethnic disparities in prescription drug use among the U.S. older adult population. METHODS: The National, Social life, Health and Aging Project (NSHAP) was used for this analysis. NSHAP is a nationally representative probability sample of 3,005 community-dwelling persons 57 to 85 years of age from households across the United States. Household interviews were conducted between July 2005 and March 2006. Multivariate logistic regression was used to examine the factors associated with differences in prescription medication use among non-Hispanic whites (Whites), non-Hispanic blacks (Blacks), and Hispanics (any race). RESULTS: In unadjusted analyses, in comparison to Whites, the use of at least one prescription medication was similar in Blacks (odds ratio [OR] 1.15, 95% confidence intervals [CI] 0.80, 1.57), but significantly less among Hispanics (OR 0.49, CI 0.38, 0.73). After adjusting for demographic and health-related characteristics including diagnosed medical conditions, Whites were significantly more likely to be using a prescription medication than either Blacks (OR 0.68, CI 0.49, 0.94) or Hispanics (OR 0.52, CI 0.37, 0.73). Racial/ethnic disparities for Hispanics were significantly reduced (OR 0.73, CI 0.47, 1.14) after accounting for insurance status and usual source of care, and racial/ethnic disparities varied by therapeutic drug class. CONCLUSIONS These data provide updated, nationally representative estimates of racial and ethnic differences in prescription medication use among community dwelling elders. hile differences in demographic and health characteristics did not explain the observed disparities in prescription drug use for blacks, socio-economic and access to care disparities may. However, differences in access to care were more important for Hispanics. In addition, differences in the use of over-the-counter drugs and dietary supplements is also evident.