Health disparities research in women’s reproductive health is evolving and racial disparities have emerged in many areas, including in assisted reproductive technology (ART), fibroid prevalence, and reproductive aging in Asian women compared to Caucasians. Observed differences in East Asian women may reflect underlying biological differences in hormone metabolism, prevalence of uterine pathology, or other undiscovered physiologic processes. They may also result from various environmental exposures, lifestyle or cultural factors, access to care, and specifics of treatments once care has been established. All of the studies investigating the disparities in ART outcomes between Asian and Caucasian women demonstrated significantly lower implantation, clinical pregnancy, and live birth rates associated with fresh embryo transfers in Asian women using autologous eggs. Higher peak estradiol levels during ovarian stimulation creating glandular–stromal dyssynchrony may be one of the explanations for the decreased pregnancy outcomes in Asian women. Later age of natural menopause and lower prevalence of premature ovarian failure have been reported in some East Asian populations compared to Caucasians. Uterine fibroids, which may affect implantation depending on their size and location, are also more prevalent in Asian women. There are still major knowledge gaps in our understanding of these racial and ethnic disparities in East Asian women. Further research to improve our understanding of the etiologies of these disparities is critical to the delivery of optimal reproductive care across our increasingly diverse society.