This study investigates how the unique circumstances of heritage language acquisition impact prosody, an understudied aspect of heritage speech. I examine the perception and production of lexical pitch accent by two generations of heritage Lithuanian speakers in Chicago (n = 13), with a qualitative comparison to one normative native speaker also living in Chicago. The speakers participated in the following: (1) a perception task requiring them to identify meaning distinctions between pairs of words that differ only by accent; and (2) a production task in which they produced sentences containing nine nominal declensions, where pitch accent plays a morphological role. In task (1), speakers across the board were not able to identify meaning distinctions in accent-based minimal pairs, irrespective of their frequency, and were more accurate at perceiving pairs that differed on the basis of segmental phonological features. However, HSs with more education perceived more accent-based distinctions, as did HSs who were more engaged in the Chicago community. Older HSs maintained more distinctions than either the NS or the younger HSs, which suggests a change in progress in the language or the Chicago Lithuanian community. In task (2), none of the speakers consistently used pitch to signal word-level prominence. Instead, all speakers relied on changes in duration and vowel quality to signal word-level prominence, suggesting that, for these speakers, there has been a shift to a stress-accent system. The older HSs was also patterned more like the NS in their retention of the expected stress in the nominal declensions. Dialect was also determined to play a role in the retention of standard accent patterns in both perception and production.