This study investigated willingness of Americans, Koreans, and Japanese to register as organ donors using the theory of planned behavior. Although previous research showed that attitude toward donation and communication with family predicted organ donation behaviors for respondents in the United States, these variables were also significant for respondents in Japan and Korea. Perceived behavioral control predicted intention to register for Japanese participants whereas knowledge about organ donation was associated with reluctance to register for Koreans. Spiritual connection and concern were shown to be causal factors underlying attitude in all 3 countries. In spite of positive attitudes toward organ donation and comparable knowledge with Americans and Japanese, most Korean participants declined to take an application to register as a donor. Implications of these findings for future research are discussed.