<b><i>Background:</i></b> Evidence is limited on ethnic differences in associations between kidney function markers and mortality or cardiovascular disease (CVD). <b><i>Methods:</i></b> Baseline cross-sectional analysis and longitudinal follow-up study of a UK population-based cohort of 1,116 Europeans and 1,104 South Asians of predominantly Indian descent, age 52 ± 7 years at baseline (1988–1991). Kidney function was estimated using Cystatin C and creatinine-based chronic kidney disease (CKD) Epidemiology Collaboration estimated glomerular filtration rate (eGFR) equations, and urinary albumin-creatinine ratio (ACR). Mortality was captured at 27 years, and incident CVD at 22 years, from death certification, medical records and participant report. Longitudinal associations between eGFR/ACR and mortality/incident CVD were examined using Cox models. <b><i>Results:</i></b> eGFR_cys was lower and ACR higher in South Asians than Europeans. eGFR_cys and ­eGFR_creat were more strongly associated with outcomes in Europeans than South Asians. Conversely, associations between ACR and outcomes were greater in South Asians than Europeans, for example, for CVD mortality: HRs (95% CI) adjusted for CVD risk factors and ACR/eGFR_cys as appropriate, <i>p</i> for ethnicity interaction: eGFR_cys: Europeans: 0.76 (0.62–0.92), South Asians: 0.92 (0.78–1.07), <i>p</i> = 0.05, eGFR_creat: Europeans 0.81 (0.67–0.99), South Asians 1.18 (0.97–1.41), <i>p</i> = 0.002, ACR: ­Europeans: 1.24 (1.08–1.42), South Asians: 1.39 (1.25–1.57), <i>p</i>= 0.23. Addition of all CKD measures to a standard CVD risk factor model modestly improved prediction capability in ­Europeans; in South Asians only ACR contributed to improvement. <b><i>Conclusions:</i></b> Strong associations between ACR and outcomes in South Asians of predominantly Indian origin, and null associations for eGFR_cys and eGFR_creat, suggest that ACR may have greater utility in CVD risk prediction in South Asians. Further work is needed to validate these ­findings.