As the number of North Korean refugees increases in South Korean, their acculturation to life in their host country is coming to be an important social issue. This study explores some clothing-related barriers experienced by North Korean refugees and their moderating effects on acculturation to South Korea. Data were collected using a self-administered survey of 163 female and 37 male North Korean refugees in South Korea aged 20 to 69 years. Descriptive analyses, t-tests, ANOVA, Duncan tests, and moderated multiple regression were conducted using SPSS 20.0 and Process Macro v.3.3. The results show that the North Korean refugees who participated in the study had experienced clothing-related barriers regarding fashion terminology and shopping rituals in South Korea. In particular, those in their 60s perceived more clothing-related barriers than those in their 20s and 30s. Next, the clothing-related barriers experienced by North Korean refugees have a negative moderating influence on the relationship between self-esteem and acculturation in South Korea. This study provides a deeper understanding of the relationship between fashion and the acculturation of North Korean refugees to South Korea. The results of the study can be also helpful of government policy makers, practitioners, and academics to develop education programs for North Korean refugees.