Background Preterm birth may leave long-term effects on the interactions between caregivers and children. Language skills are sensitive to the quality of caregiver-child interactions. Aims Compare the quality of caregiver-child play interactions in toddlers born preterm (PT) and full term (FT) at age 22 months (corrected for degree of prematurity) and evaluate the degree of association between caregiver-child interactions, antecedent demographic and language factors, and subsequent language skill. Study Design A longitudinal descriptive cohort study Subjects 39 PT and 39 FT toddlers individually matched on sex and socioeconomic status (SES) Outcome Measures The outcome measures were dimensions of caregiver-child interactions, rated from a videotaped play session at age 22 months in relation to receptive language assessments at ages 18 and 36 months. Results Caregiver intrusiveness was greater in the PT than FT group. A composite score of child interactional behaviors was associated with a composite score of caregiver interactional behaviors. The caregiver composite measure was associated with later receptive vocabulary at 36 months. PT-FT group membership did not moderate the association between caregiver interactional behavior and later receptive vocabulary. Conclusions The quality of caregiver interactional behavior had similar associations with concurrent child interactional behavior and subsequent language outcome in the PT and FT groups. Greater caregiver sensitivity/responsiveness, verbal elaboration, and less intrusiveness supports receptive language development in typically-developing toddlers and toddlers at risk for language difficulty.