Objectives To assess the status and change in self-rated health among Aussiedler, ethnic German immigrants from the former Soviet Union, as a predictor for premature death 10 years after first assessment. Moreover, to identify subgroups which are particular at risk of anticipated severe health impairment. Design Cross-sectional questionnaire. Setting The study was conducted in the catchment area of Augsburg, a city in southern Bavaria, Germany, in 2011/2012 that has a large community of Aussiedler. Participants 595 Aussiedler (231 male, 364 female, mean age 55 years) who in majority migrated to Germany between 1990 and 1999. Outcome Primary outcome: self-rated health (very good/good/not so good/bad) and its association with demographic, social and morbidity related variables. Methods Self-rated health was dichotomised as 'very good' and 'good' versus 'not so good' and 'bad'. Multivariable logistic models were created. Missing values with regard to pain were addressed by a second analysis. Results Although low response suggests a healthier sample, the findings are alarming. Altogether47% of the Aussiedler perceived their health as less than good, which is worse compared with the first assessment in 2000 (25% compared with 20% of the general public). Prevalence of high blood pressure was present in 52% of Aussiedler, 34.5% were obese, 40.7% suffered from frequent pain and 13.1% had diabetes mellitus. According to the multivariable models, individuals suffering from pain, limited mobility, diabetes mellitus and high blood pressure are particularly in jeopardy. Conclusions 10 years after the first assessment of self-rated health among Aussiedler their situation deteriorated. Tailored risk factor counselling of general practitioners is highly recommended.