Patients who do not speak the same language as their healthcare professional receive limited health services compared with those who do, which may result in poor health outcomes. Speech-language therapists in multilingual and multicultural hospital settings often face these challenges. Language and translation issues have a marked impact on information received by patients and their families or caregivers. Despite clinicians’ challenges experienced in multilingual settings, they seem to find that their working experience is an important leveller when there is an interpreter present during consultations. Human or linguistic rights-based teaching frameworks should include how to work with interpreters and be a culturally competent clinician. Evidence suggests a slowly increasing number of African language-speaking speech and hearing therapists. There is evidence that some of the existing workforce in the public and private sectors are not culturally competent, as required by the Health Professions Council of South Africa (HPCSA). Academic curricula and the clinical practice of speech-language and audiology students and professionals should transform application of theoretical knowledge when treating speech and hearing disorders in a multilingual and multicultural context, enhancing the efficacy of management of communication disorders. Furthermore, the profession needs to work on developing culturally and linguistically relevant intervention tools.