Is migration from isolated indigenous island communities to Panama City associated with an increase in stress? Individuals were randomly sampled from two Kuna communities: 325 individuals in Panama City and 133 on a Caribbean island. Stress was assessed through the Milcom questionnaire, which explores physical symptoms and symptoms relevant to mood and emotional state, and Cantril's ladder, which examines life satisfaction. Physical symptoms were more common in the urban community (p < 0.001), and complaints reflecting mood were also significantly higher on the mainland (p < 0.001); the two measures were highly correlated. While systolic and diastolic blood pressure was higher in the mainland community (p < 0.001), there was no relation between blood pressure level and any index of stress. Despite unambiguous evidence of an increase in stress in migrants to the city, there was no indication that the stress contributed to the rise in blood pressure level. Migration to an urban setting is associated with an increase in physical symptoms and symptoms reflecting depressed mood, suggesting increased stress level. Life satisfaction is less influenced, possibly providing a measure of the degree of stress.