Objective <p>There are higher rates of adverse childhood experiences (ACEs) among Hispanic youth relative to non-Hispanic White youth in the United States (U.S.). Systemic factors, including economic inequities, educational disparities, and discriminatory policies, contribute to Hispanic youth having an increased risk for greater ACEs relative to non-Hispanic White youth. This study examined the associations between state-level structural ethnoracism (i.e., social inequality relative to non-Hispanic Whites) and cumulative ACEs risk between non-Hispanic White and Hispanic youth.</p> Method <p>Data on ACEs and demographic variables from the 2020 National Survey on Children’s Health (<i>n</i> = 34,047) and state-level indicators of structural ethnoracism (<i>n</i> = 50) were utilized.</p> Results <p>The highest state-level structural ethnoracism scores were observed among Northeastern states, while the lowest scores were found among Central Appalachian states. Hispanic youth had significantly higher average rates of ACEs overall and within 19 of 50 states relative to non-Hispanic White youth. Multilevel model analyses showed that as state-level structural ethnoracism increased, youth’s ACEs decreased significantly for non-Hispanic White youth but not Hispanic youth. However, the multivariate main effects (4.8%) and interaction model (4.9%) suggest that the variance explained in cumulative ACE scores was relatively small.</p> Conclusions <p>Our results align with previous research demonstrating that the historical and institutional effects of structural ethnoracism may convey health benefits to White non-Hispanic youth through greater access to resources and opportunities. Our findings highlight a need for research and interventions to address systemic factors contributing to disparities in ACEs risk that can result in mental health problems.</p>