Language and cultural barriers to medical care are a large and growing problem in the United States. A number of federal and state laws, as well as professional and accreditation standards, require and encourage health care organizations to provide culturally and linguistically accessible health care. In this paper we outline those laws, regulations, and standards, describe how they apply in an emergency department (ED) setting, and outline a stepwise approach that EDs can take to improve their compliance with these laws and the linguistic and cultural accessibility of the care that they provide.