Health disparities related to food choices, nutrition behaviours and smoking habits in urban communities in the United States signal the importance of health education (HE) in schools, yet educators in urban communities face unique cultural challenges often unaddressed in professional development (PD). The purpose of this study was to use a cultural competence framework to examine urban HE teachers' perspectives of culturally competent PD. Ethnographic fieldwork was conducted at PD planning and training sessions, and 23 HE teachers were observed teaching and interviewed over two school years as they experienced PD and implemented revised curriculum with their middle-school students. Four themes regarding issues of cultural competence in PD interventions emerged during the study. These included: the need for diverse and credible PD staff; culturally competent curricula; flexible implementation expectations; and follow-up support beyond PD workshops. The findings of this study highlight the teachers' perceptions of PD efforts that would align best with the complex teaching situations of urban schools, demonstrating a rich understanding of and participation in urban school communities.