This article compares lexical and grammatical abilities of a mental-age-matched sample of Italian preschoolers with Down syndrome (DS), specific language impairment (SLI), or typical development. Results showed that the children with DS or with SLI performed significantly worse than did the typically developing children. Although no significant differences emerged in lexical abilities and morphosyntactic comprehension abilities between the children with DS or with SLI, significant differences did emerge in morphosyntactic production capacities. Qualitative analysis of the morphosyntactic errors revealed strong similarities between the two groups. The results are discussed in terms of the role of verbal memory abilities and the linguistic features of Italian.