According to the 2010 U.S. Census Bureau, there are 8.5 million children enrolled in the school system who speak Spanish in their home, thousands of whom speak little to no English before kindergarten. This diverse population has continually increased throughout the past years, and with this growth, speech-language pathologists (SLPs) have been faced with the challenge of assessing the speech and language of these children. In assessing a Spanish-speaking child, even if the child is also proficient in English, there are numerous factors a SLP must consider, such as the language acquisition process, the impact of language interference, and the form of assessment that will be used. Thus, the purpose of this paper is to review the current situation of the speech and language assessments of bilingual Spanish- English speaking children. In doing so, numerous aspects of the process will be covered, including specific language phonologies, identification of a true language disorder, as well as various forms of alternative assessments. Finally, this paper will conclude with the consequences that often follow the misdiagnosis of a bilingual child's speech and language. Thus, SLPs may use some of the recommendations made in this paper to prevent such misdiagnoses and ensure a more accurate assessment of the Spanish-English speaking children on their caseloads.