Illustrated health resources are useful for people who have limited English linguistic ability. The aim was to compare the preferences of resettled refugees from Africa and non-African countries, on pictograms describing common symptoms of illness. Data were collected in two cities in Queensland, Australia. Participants indicated their preference for three types of pictograms depicting seven symptoms. Pictogram sources included the International Pharmaceutical Federation, royalty-free stock images, and pictograms designed in South Africa. For all ailments, participants (n = 81) from Africa preferred the African pictograms more than participants not from Africa (n = 61). A significant association was found between pictogram preference and where respondents were from for each ailment except headache (p = 0.375). African refugees showed a significant preference for pictograms which had been culturally adapted for an African population; however, some other refugees also preferred certain African pictograms. Pictograms for resettled refugees should be pre-tested to determine acceptability, as they should be culturally relevant.