Immigrants, especially the first-generation, were thought to have different knowledge, attitudes and practice (KAP) with antibiotics. Doctors often perceived extra pressure from them to prescribe antibiotics. To test these perceptions, we studied the difference in KAP with antibiotics between the recent-immigrants from mainland China and the local-born of Hong Kong-places with significantly different healthcare and socio-economic systems. Focus groups (including one specific group of recent-immigrants) with 56 participants and territory-wide telephone questionnaire survey with 2,471 randomly selected respondents. Recent-immigrants shared similar KAP with the local-born. After adjustment for age, sex and education, the main significant difference was the new-immigrants' behaviour of acquiring antibiotics without prescription and keeping the leftover. They, like the local-born, preferred doctors who prescribed antibiotics cautiously. Immigration status could be the surrogate for age, sex and education in the KAP with antibiotics. For antibiotic use, health education and patient care could be similar between the recent-immigrants and the local-born.