To determine if language barriers affect the level of asthma management and quality of health care in Latino children, a cross-sectional, parent-report survey was conducted in 26 randomly selected public elementary schools in New York City. The overall response rate was 76.9%, yielding a sample of 1,847 Latino children. The prevalence of asthma among Latinos from Spanish-speaking households was 20.8%, compared with 25.8% among Latino children from English-speaking households. Although asthmatics from Spanish-speaking families were less likely to have symptoms than children from English-speaking families, they were twice as likely to be hospitalized for asthma (9.4% vs. 4.4%, p<.02). Asthmatics from Spanish-speaking households were more likely to have public health insurance and to use a community/hospital clinic for care. Spanish-speaking parents were less likely to report having access to care on weekends or to have communicated with their child’s physician about recommended components of an asthma management plan.