In the search to understand the basis of performance discrepancies, many clinicians are recognizing that, often, factors with no direct relationship to brain functioning influence performance on neuropsychological measures of cognition among children and adolescents. The emergent research on cross-cultural neuropsychology indicates that while the test performance discrepancies do indeed exist, they can be explained by a number of other factors, some of which are known and others that have yet to be operationalized or even identified. While a review of all such factors is beyond the scope of this article, an examination of those that have received the most attention is presented: factors associated with the examinee, factors associated with the neuropsychological measures, cultural competency of the examiner, and factors at the organizational/political level.