Background: Online health information is underutilized among Hispanics with low English proficiency in the U.S. This study examines the association between a unique measure of general English literacy, language use, and online health information seeking among Hispanic adults. Methods: Data for Hispanics ages 25-65 (N?=?700) come from the 2012/2014 Program for International Assessment of Adult Competencies (PIAAC). Binary logistic regression models were used to predict online health information seeking as a function of literacy skill scores (0-500 points) and primary language use (Spanish vs. other). Results: Literacy (Odds-Ratio?=?1.012, p?< 0.001) was a positive predictor, while speaking Spanish at home (Odds-Ratio = 0.352, p?< 0.01) was a negative predictor of online health information seeking. Conclusion: Literacy skills and language use appear to be separate contributors of online health information seeking among Hispanic adults. Practice implications: Online health information providers should be aware of literacy skills and Spanish language use as barriers to online health information seeking among Hispanics, particularly those who have both limited literacy skills and predominantly Spanish language use. [This is the in press version of an article published in "Patient Education and Counseling" (ISSN 0738-3991).]