The study examined the interrelationships between parental distress, family processes, and child depressive symptoms among Korean American families. Path analyses was used to examine the effects of parents’ culturally specific and somatic symptoms of mental distress on parent–child relationships and child mental health outcomes among a sample of Korean American youth (N = 220), mothers (N = 272), and fathers (N = 164). Independent analyses for fathers and mothers revealed that for Korean American fathers, both cultural symptoms and somatic symptoms were directly related to youth-reported dimensions of family process and indirectly with youth depression. For mothers, direct and indirect pathways between parental distress (i.e., culturally specific and somatic symptoms) and youth depression were non-significant. Our findings suggest that family interventions with Korean immigrant families should consider cultural and gender-specific factors in both parental mental health and family relationships.