Breast cancer is the leading cancer in both incidence and mortality for Asian Indian women. The breast cancer screening rates for Asian Indians are also among the lowest across several racial and ethnic groups in the United States (US). However, few studies have investigated factors associated with breast cancer screening rates for Asian Indian women in the US. The objective of this study was to assess sociocultural predictors of adherence to American Cancer Society breast cancer screening g uidelines for Asian Indian women residing in the greater Houston area. We hypothesized that low knowledge of breast cancer/breast cancer screening and negative attitudes such as stigma toward breast cancer screening would be significant predictors of adherence to screening guidelines. Surveys were designed using a Knowledge, Attitudes, Practices (KAP) analysis framework and were distributed to a convenience sample of 104 India-born Asian Indian women over the age of 45. Knowledge was measured using true/false questions about breast cancer and breast cancer screening. Attitude was measured using agree/disagree statements related to perceived stigma, internalized stigma, and sociocultural barriers to breast cancer screening. Multivariable logistic regression analysis revealed that attitude was a significant predictor of adherence to screening guidelines [OR = 0.858 (95% CI: 0.768 - 0.937); P = 0.002], but knowledge was not [OR = 1.16 (95% CI: 0.478 - 2.759); P = 0.736]. The findings from this study can guide the development of educational interventions that focus on improving health literacy and increasing breast cancer screening adherence for Asian Indian women.