Immigration is a social determinant of health that can be divided into the time-based categories of premigration, during-migration and postmigration. Latino immigrants face numerous threats to their health during each phase of the migration journey, such as premigration violence, hazardous conditions during migration and postmigration discrimination. This is a report of a child who fled violence to seek asylum in the USA and was subsequently diagnosed with supravalvular aortic stenosis, which required cardiac surgery repair. The case analysis uncovers challenges and facilitators to health for immigrants with barriers to documentation at policy, organisational and interpersonal levels and makes suggestions to advance health equity in the USA. The exclusion of immigrants with barriers to documentation from healthcare, uneven distribution of charity care, inadequate language services and provider biases are among the key issues addressed.