Background. Medical patients with limited English proficiency (LEP) frequently receive health care services of suboptimal quality. Methods. We explored whether clients served with staff interpreters (language-discordant, LDI) receive reproductive health care of lower quality than clients seen by a bilingual clinician (language concordant, LC). We conducted a medical record review of 1,589 reproductive health visits of female and male LEP clients. Results. Multivariate analyses showed that LDI visits were significantly less likely than LC visits to contain documentation of the provision of education and counseling services and less likely to have documentation of sexually transmitted infection (STI) risk assessment among new female clients. Female clients in LDI and LC visits were equally likely to be tested for Chlamydia. Conclusions. Quality improvement activities should target family planning providers who must use interpreters when serving LEP clients. Medical charts should document the use of interpreters and bilingual clinicians to monitor quality of care.