Despite a vibrant trajectory, the specialty of clinical neuropsychology has largely ignored the role of sociocultural variables in understanding the impact of brain dysfunction on individuals. This chapter addresses the long held bias against linguistic and cultural variables in neuropsychological assessment. The emphasis, however, is on Spanish-speaking individuals, especially those residing in the United States. This is done because of the expanding demographics of Hispanics as well as the growing neuropsychological literature on these individuals. Both clinical strategies and scientific issues are addressed. Pragmatic suggestions are provided and limitations to existing information are addressed.