In an increasingly interconnected world, the dynamics of relationships are undergoing significant transformations, particularly within multilingual couples where language proficiency plays a crucial role. This review presents a conceptual framework aimed at exploring the intricate interplay between language proficiency and therapy outcomes in such relationships. Understanding the impact of language proficiency on therapy outcomes necessitates a multidimensional approach. Firstly, it requires an examination of the linguistic competencies of each partner within the relationship. Proficiency in multiple languages can influence communication patterns, affective expressions, and the negotiation of conflicts, thereby shaping the therapeutic process. Additionally, cultural factors intertwined with language proficiency further contribute to the complexity of therapeutic dynamics within multilingual couples. Furthermore, this conceptual framework emphasizes the importance of considering the socio-linguistic context in which therapy takes place. The power dynamics associated with language use, including dominance, fluency, and language preference, can significantly influence the efficacy of therapeutic interventions. Moreover, language barriers may hinder the expression of emotions and the resolution of conflicts, posing unique challenges to the therapeutic process. Moreover, the framework underscores the significance of therapist competence in navigating linguistic and cultural diversity within multilingual couples. Therapists must possess not only linguistic proficiency but also cultural sensitivity and awareness to effectively address the unique needs and challenges faced by these couples. Culturally responsive therapeutic approaches, such as multilingual therapy modalities and language mediation techniques, can facilitate a more inclusive and effective therapeutic process. This conceptual framework offers a comprehensive lens through which to examine the impact of language proficiency on therapy outcomes in multilingual couples. By acknowledging the complex interplay between language, culture, and therapy, researchers and practitioners can better understand and address the unique needs of these couples, ultimately enhancing the efficacy and inclusivity of therapeutic interventions.