In this paper, we consider some of the challenges associated with the ethical need to conduct locally relevant international health research. We examine a cervical cancer research initiative in a resource-poor community in South Africa, and consider the extent to which this research was relevant to the expressed needs and concerns of community members. Results from informal discussions and a series of 27 focus groups conducted in the community provide insight into the community's needs and concerns, and its recommendations for how the research could be made more relevant to the community. We discuss these findings in the context of recent theory and literature on the role of community engagement in promoting local relevance and responsiveness in community-based health research. We anticipate that the paper's findings may help international health researchers better identify and assess the challenges of conducting locally relevant research across major global gaps in wealth and health.