Health research needs to reflect meaningful ethnic diversity in research design and recruitment. This chapter outlines some of the factors that both contribute and perpetuate barriers to effective representation of minority ethnicities in research and concludes with some recommendations that can be adopted to improve engagement of minority ethnicities in research as a forethought in research design and application.The term minority ethnics is used in recognition that white people also have ethnicities but is interchangeable with ethnic minorities. The chapter uses examples of how the two largest minority ethnicities comprising South Asians and African-Caribbeans in the UK are consistently under-represented in health research of diabetes, dementia, cardiovascular and cancer medicine where they are disproportionately over-burdened compared to the white population. As a consequence, much of the good research in these conditions is mainly based upon white populations with generalisation to other minority ethnic groups. We highlight how disaggregation of ethnic population data is essential to identify differential cultural, social and health needs and how generalisability of health interventions are potentially flawed by a lack of minority ethnic representation leading to either inaccurate or ineffective health interventions that lead to poorer health outcomes.Despite little research into the factors that contribute to this under-representation, the few studies that exist help outline their origins within historical, cultural, experiential and perceptual mistrust perpetuated by systematic and institutional racism. These key barriers need to be understood to avoid perpetuating these pitfalls in future research. The chapter concludes with ways to facilitate and implement solutions guided by the principles of community-based participatory research.