This chapter explains how racial residential segregation affects the health of Black Americans. Housing is highly racially segregated in most American cities. While this occurs to some extent because people want to live with other people similar to them, it is primarily due to governmental policies and private business practices that created widespread residential segregation by severely restricting where Black people could live. The neighborhoods to which Black Americans were relegated were typically in undesirable areas, physically separated from the larger community, and containing few resources. Once these neighborhoods were created, the practices of banks (e.g., refusing loans) and real estate firms (e.g., restrictive covenants) made it difficult for Black Americans to improve these areas or to leave them. Living in these neighborhoods makes poverty more likely, which, by itself, is associated with poorer health. These neighborhoods are also more likely to have high levels of environmental toxins (e.g., polluted air and water), limited availability of healthy food, unhealthy built environments (e.g., dangerous housing, absence of green spaces), and limited access to healthcare. In sum, residential segregation, which is the product of anti-Black racism, creates living conditions that threaten Black Americans’ health.