Background Understanding how individuals make decisions about Pap tests concerning their personal values helps health‐care providers offer tailored approaches to guide patients’ decision making. Yet research has largely ignored decision making about Pap tests among immigrant women who experience increased risk of cervical cancer. Objective To explore decision making about Pap tests among Korean immigrant women. Methods We conducted a qualitative descriptive study using 32 semi‐structured, in‐depth interviews with Korean immigrant women residing in a north‐eastern metropolitan area. Data were audio‐recorded, transcribed verbatim and analysed using inductive coding. Results Although most women with positive decisions made their own decisions, some women deferred to their providers, and others made decisions in collaboration with their providers and significant others. While women making positive decisions tended to consider both barriers to and facilitators of having Pap tests, women making negative decisions predominantly discussed the barriers to having Pap tests, such as modesty and differences between the South Korean and US health‐care systems. The women's reflections on their decisions differed regarding their Pap test decisions. Conclusions Women's desired roles in the decision‐making process and reflection on their decision outcome appeared to vary, although most participants with positive decisions made their own decisions and were satisfied with their decisions. Future research should conduct longitudinal, quantitative studies to test our findings regarding decision‐making processes and outcomes about Pap tests. Implications The findings should be incorporated into cervical cancer screening practices to fulfil the unmet needs of immigrant women in patient‐provider communication and to facilitate women's decision making about Pap tests.