Purpose: Black communities experience higher rates of preventable health inequities, such as uncontrolled blood pressure (BP), pain, and overall health challenges. The Nurses 4 Black Well-being (N4BW) project explores these inequities through a health promotion lens. Spirituality has been shown to be a positive culturally relevant health factor that is central to holistic nursing efforts. Therefore, this study explored relationships between self-rated spirituality and health outcomes (BP, pain, and overall health) among marginalized Black community adults. Design: A cross-sectional quantitative study was conducted. Methods: Surveys were administered to a convenience sample of N = 203 Black adults across local community sites in marginalized areas in the Midwest United States, with support from key community partners. Theistic and non-theistic spiritual experiences, systolic BP, pain, and self-rated health were assessed using standardized assessments. Findings: Regression analyses found no significant health effects for theistic or non-theistic spirituality across outcomes of systolic BP, pain, and self-rated health. Conclusion: While spirituality remains a central concept in holistic nursing, these findings suggest that its relationship with health may be more nuanced than previously understood.Additional holistic nursing research exploring spirituality's role in the health and holistic well-being of marginalized Black community adults is needed.