Nearly 32 million people in the United States, 13.8 percent of the population, speak a language other than English at home, and our health care delivery system is hard-pressed to handle this diversity. Most pressing is the need for adequate translation services. Many U.S. hospitals rely on untrained employees or advise patients to bring friends or family members with them to translate. Thus, interpreter and translation needs often go unmet or are handled inappropriately. A number of federal and state laws impose legal obligations on health care providers to offer at least minimally adequate translation services for limited English-proficient patients. This article outlines the scope of these legal requirements and discusses the need to ensure linguistically appropriate care in the emerging managed care delivery system.