Objective. To compare parents’ experience with the early intervention (EI) referral process based on health literacy level. Methods. We interviewed 44 parents of children referred to EI by their pediatricians. Parents completed the Newest Vital Sign (NVS) health literacy assessment. We analyzed transcripts using modified grounded theory and compared themes based on health literacy. Results. Forty parents completed the NVS. Twenty-eight (70%) had adequate health literacy. Four primary themes differed between parents based on health literacy level. Parents with low health literacy commonly reported that: (1) they lacked continuity with a single pediatrician, (2) they had difficulty contacting EI, (3) they were confused about EI or the referral process (4) their pediatricians did not explain EI and written materials were not helpful. Conclusion. Parents with low health literacy commonly reported difficulty with EI referrals including contact problems and confusion. Strategies that accommodate parents with low health literacy level may improve referral success.