Previous research has identified that MMSE scores vary by education raising concern that examinees with lower educational level may be inaccurately identified as cognitively impaired. Most studies, however, used the English MMSE and may not generalize to Spanish speakers. We compared MMSE scores in primary Spanish-speakers tested in English (S-E) with primary Spanish-speakers tested in Spanish (S-S). This project involved secondary analysis of de-identified National Alzheimer's Coordinating Center data. Cases with visit one MMSE data and demographics were included if the primary language was Spanish yielding a sample of S-S (n = 1514) and S-E (n = 346) participants. Coarsened exact matching derived a subset of S-E and S-S participants matched on age, education, and Clinical Dementia Rating global score (n = 630). In the overall sample, groups were not different in age, but education was lower in S-S (M = 9.2; SD = 5.1) than S-E (M = 12.9; SD = 5.1; p < 0.001) participants. MMSE scores were lower in S-S (M = 22.4, SD = 7.1) than S-E participants (M = 23.7, SD = 6.2; p = 0.002). More S-S participants (45%) had an abnormal (< 24) MMSE compared to S-E participants (38%; p = 0.02). In the matched sample, MMSE scores were not significantly different between S-S (M = 24.4; SD = 6.0) and S-E (M = 23.9; SD = 6.1; p = 0.30) participants, and rates of abnormal MMSE scores were not significantly different between S-S (32%) and S-E (37%; p = 0.16) participants. Overall sample MMSE scores differed by test administration language groups, but group differences were not observed in the matched subset. Consistent with other research, educational level is associated with MMSE scores in Spanish-speakers regardless of test administration language.