South Africa’s populace is characterised by large differences in health, with vast inequalities between members of different groups that can be identified by using a number of tested health indicators, with self-assessed health (SAH) status amongst them. Generally, the average White person’s health, however measured, is considerably better than that of Black African persons with the health of Indian and Coloured persons somewhere between the two. Typically, this pattern is attributed to the continued association between race and socio-economic status. Recent empirical work conducted, however, seems to cast doubt on the validity of the assumption that SAH can be compared directly across members of different groups. In light of this concern, and the challenge which it poses to the interpretation of the results of much current South African empirical work, this article explores possible systematic differences with respect to the perception and reporting of SAH between members of different race groups in South Africa. Using data drawn from a nationally representative survey of approximately 3000 respondents, this study analysed racial differences in SAH alongside domain-specific SAH and attitudes to a number of health-related areas (e.g. reference groups, perceptions of main influences on health, etc.). The analysis revealed a number of differences when compared to the usual racialised pattern observed. It is held that these differences suggest that there might be a role for race to play in the assessment and reporting of SAH independently of its continued association with socio-economic status.