Digital math assessments with bilingual accommodations allow multilingual learners to use their entire linguistic repertoire to showcase their knowledge and skills. The bilingual accommodations, which include tools like language translation and audio prompts in both English and Spanish, are designed to be adaptable, giving multilingual learners the freedom to view or listen to the items in either language and to write or say their responses in either language or a combination of both. This study examined how 56 middle school emergent bilingual learners used these bilingual accommodations and explored the perceptions of teachers and students regarding these accommodations. This study provides evidence regarding using bilingual accommodation in math assessments for middle school emergent multilingual learners. The results showed how students used their full linguistic repertoire and language modalities to showcase their math knowledge and skills. Both teachers and students reported having positive perceptions of the bilingual accommodations, reinforcing its responsiveness to different learners’ needs and preferences.