The purpose of this study was to compare the novel word learning skills between Cantonese-English bilingual children at risk for developmental language disorder (DLD) and their typically developing (TD) peers. Participants were 24 Cantonese-English bilingual preschool children at risk for DLD and 38 TD children. Each participant was presented with eight novel words in Cantonese (first language [L1]) and eight in English (second language [L2]) over eight weekly sessions. Children's existing lexical knowledge was measured using the moving-average number of different words in language samples in L1 and L2. Bilingual children at risk for DLD were scored lower than their TD peers for both languages over time. The role of lexical knowledge in children's word learning differed between the TD and DLD groups: Lexical knowledge in L1 was a predictor of L1 word learning in TD children, while lexical knowledge in L2 predicted L2 word learning in children at risk for DLD. In addition, significant cross-linguistic effects were found from L2 to L1 for both groups. This study underscores the complexity of novel word learning in bilingual children at risk for DLD. Clinically, these findings suggest the value of tracking learning trajectories in bilingual children across both languages.