There are up to 420 millions of people speaking Arabic all over the world and Arabic is the fourth spoken language. The Arab world consists of twelve countries in Asia and ten in Africa. Neuropsychological Tests (NPT) are available mainly in English or other Europeans languages. Arabic speaking clinicians are confronted to several difficulties as suitable standardized tools are lacking. Adaptation in Arabic implies not only a simple but also a back translation, piloting, and cultural adaptation of both verbal and nonverbal tasks. The Arab world is quite heterogeneous and adaptation of NPT poses several problems. Concerning for example the Free and Cued Selective Reminding Test (Grober et Buschke, 1988), the main problem faced by our team in Rabat was the unavailability of words frequency in Moroccan Arabic. It was thus necessary to study that first and then we were able to set lists of words classified according to their frequencies and semantic categories (Azdad et al., 2016). Adaptation of tests in Arabic must consider the linguistic diglossia (Fergusson, 1959). In the Arab countries, people use two variants of Arabic, a dialectal Arabic and a modern standard one. The dialect(s) spoken in everyday life differs from one country to another. The modern standard Arabic is used in school, books and mass media and is the same in all Arab countries. NPT should use the local dialect for the oral instructions because giving them in standard Arabic would be artificial, and the standard Arabic for the written language. This approach has been used for all the adaptations we performed until now, such as the Mini Mental State Examination (Folstein, 1975), the Montreal Cognitive Assessment (MoCA) (Nasreddine, 2005), the Mattis Dementia Rating Scale (MDRS) (Mattis, 1976) and other tests. During our adaptation of the MMSE for example, one difficulty was to find a sentence equivalent to “No ifs, ands or buts” [[3]El Alaoui Faris M. Benabdeljlil M. Boutazount N. Mourji F. Agoulmame M. Rahmani M. Berramdane M. Aït Benhaddou H. Ettahri L. Chkili T. Adaptation et validation du Mini Mental State Examination (MMSE) en arabe.Rev. Neurol. (Paris). 2003; 159: 146Google Scholar]. For the Moroccan version of the MoCA [[1]Azdad A. Benabdeljlil M. Al Zemmouri K. El Alaoui Faris M. Standardization and validation of montreal cognitive assessment (MoCA) in the Moroccan population.International Journal of Brain and Cognitive Sciences. 2019; 8: 1-5Google Scholar], the two sentences for the « Language-sentence repetition » item were replaced by two sentences in Arabic dialect to reflect local familiarity and we had then to check their validity during a pilot study. Concerning the language-verbal fluency, we chose the letter (ب) (b) for the phonemic letter fluency subtest according to our previous standardization study of this test. A cognitive test could be used in any Arab country, but needs modifications from one country to another for the dialectal part. Culturally adaptation is also needed for non-verbal items such as changing images or figures places, as we did with the items “construction” and “initiation” in the Moroccan adaptation of the MDRS [[5]Sanhaji S. Elargoub I. Lemaréchal C. Benabdeljlil M. El Alaoui Faris M. Moroccan version of the mattis dementia rating scale: the effects of age, education, and gender.World Journal of Neuroscience. 2018; 8: 90-97Google Scholar], where figures were moved from the left to the right side of the sheet. Furthermore, differences exist in the Arab world and even between regions in the same country in term of quality of education. It is mandatory that each country has its own norms, distributed by age bracket, gender and educational level. NPT should also be validated in each country, in order to check their sensitivity. Using unvalidated tests without local normative data entails a risk of wrong assessments and misinterpretations. Otherwise there is an overall high rate of illiteracy in the Arab speaking areas. Usual NPT could not be used in illiterates to whom specific tools should be proposed using only non-written material. [2Abdelhak Azdad A. Fatima Boutbibe F. Benabdeljlil M. El Alaoui Faris M. Adaptation and standardization of the free and cued selective reminding test to the Moroccan population.International Journal of Brain and Cognitive Sciences. 2016; 5: 7-14Google Scholar, 4Ferguson C.A. Diglossia.WORD. 1959; 15: 325-340Google Scholar]