OBJECTIVE: To examine the impacts of long-standing obesity (BMIs â‰¥ 30.0 kg/m(2)) on health outcomes among Samoan and Tongan men (aged â‰¥ 18 years) in California using a life course perspective. DESIGN: Cross-sectional analysis of 103 males from the Pacific Islander Health Study (PIHS), a probability sample modeled after the National Health Interview Survey (NHIS). SETTING: Urban residential neighborhoods in San Mateo and Los Angeles counties using a multistage, cluster sample design. MAIN OUTCOME MEASURES: BMI, diabetes, hypertension, total cholesterol, smoking, drinking, arthritis, gout and migraines. RESULTS: Bivariate analysis shows high rates of poor health outcomes distributed throughout the obese and non-obese sample. Logistic analysis finds that being obese does not significantly increase observed negative health outcomes. After controlling for socio-demographic characteristics, the presence of obesity results in non-significant findings for hypertension (OR=1.02; CI: .21, 4.91), and high cholesterol (OR=.52; CI: .10, 2.73), while obesity significantly reduces the risk of diabetes by 60% (OR=.40; CI: .14, 1.17). When applying disease counts, obese men have a significantly lower risk of reporting multiple health conditions (OR=.72; CI: .52, 1.00). CONCLUSION: Overall, the health of Samoan and Tongan males in California is uniformly poor and obesity alone does not significantly increase risks of poor health outcomes. Using a life course perspective, the analysis offers new insights on the basic health of this understudied population.