Older immigrant women experience several barriers in accessing health care. In this study, we explored how older Pakistani women are met with, and respond to, barriers to health care in Norway, using an ethnic boundary-making and intersectionality approach. Our data included interviews with 23 older Pakistani women and 10 caregivers. We found that ethnic boundaries were constructed in healthcare interactions and were influenced by participants' social positions. At the micro level, the interplay of language barriers and being an immigrant fuelled the making of ethnic boundaries. At the macro level, ethnicised cultural discourse in the public sphere fuelled the making of ethnic boundaries in health care. Having encountered ethnic boundaries in health care, older Pakistani women actively coped through compensatory, de-stigmatising and boundary-modifying strategies.