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Immigrant caregivers and their children encounter manifold barriers to mental health service use with unique challenges in the U.S.-Mexico border region. This study examined predisposing, enabling and need factors associated with mental health service use by immigrant caregivers and their children. A cross-sectional survey of 240 immigrant caregivers with children living in New Mexico was conducted. Three domains were examined for their associations with mental health service utilization among caregivers and children. Domains included predisposing (caregiver age, household composition, gender, education, religiosity, duration of US residency, adverse childhood experiences, English proficiency), enabling (caregiver resilience, employment, income, insurance status, health/social service use, social safety net use, resource navigation, help-seeking attitudes), and need (depression symptoms, immigration stress, housing insecurity) factors. Multiple logistic regression models were constructed for each domain and significant variables at a p < 0.05 level were included in final models. In the final model, caregiver mental health service utilization was positively associated with help-seeking attitudes and depression symptoms. For children, mental health service utilization was positively associated with health/social service use. This study identifies factors that may impact the use of mental health services by immigrant families living along the US-Mexico border. Results highlight the importance of culturally informed mental health outreach and integrating mental health services within coordinated and supportive health, social, and safety net services.