Culture – the foundation of views about health and healing – is subject to modification, translation, and adaptation as it grapples with changes in its geographic, economic, and socio-political context. For the Hmong, an Indigenous people with a millennia-long history of regional and international migration, it can be said that their cultural context has been change itself. Given the empiricist certainty that Indigenous medical systems will invariably yield to modern education and the increased availability of biomedical services, the perpetuation of various traditional elements in the medical culture of the Hmong is nothing short of remarkable. As minorities in a dominant society that rejects their ontology of health, the retention of a distinct mytho-cultural medical identity has been a choice on the part of the Hmong in Southeast Asia and the diaspora. Not only has traditional Hmong medical culture persisted in the face of (supposedly) stronger cultures of modernization, scientific rationality, and state power, but the practices and conceptualizations enshrined in traditional healing have also come to constitute a form of resistance to cultural colonization, cognitive imperialism, and social assimilation. This paper examines the ontology of health and traditional medicine among the Hmong in Southeast Asia and the United States. An analysis of the forces driving change or supporting continuity in the healing practice and the ontology of health reveals how the Hmong have managed to reconcile ‘tradition’ and ‘modernity’ – bio- and ethno-medicine – without conceptualizing these realms as mutually exclusive.