Emergency Department (ED) physicians are routinely confronted with problems associated with language barriers. It is important for emergency health care providers and the health system to strive for cultural competency when communicating with members of an increasingly diverse society. Solutions include professional interpretation, telephone interpretation, the use of bilingual staff members, the use of ad hoc interpreters, and more recently the use of mobile computer technology at the bedside. Each method carries a specific set of advantages and disadvantages. Although professionally-trained medical interpreters offer improved communication, better patient care, and overall cost savings, they are underutilized due to their perceived inefficiency. Ultimately, the solution will vary for every Emergency Department (ED) depending on the population served and available resources. Accessibility of the multiple interpretation options outlined above and solid support and commitment from hospital institutions are necessary to provide proper and culturally competent care for patients. Appropriate communications inclusive of interpreter services are essential for culturally competent provider/health systems and overall improved patient care.