Purpose: Identification of speech sound disorder (SSD) in children who are multilingual is challenging for many speech-language pathologists (SLPs). This may be due to a lack of clinical resources to accurately identify SSD in multilingual children as easily as for monolingual children. The purpose of this article is to describe features of multilingual speech acquisition, identify evidence-based resources for the differential diagnosis of SSD in speakers of understudied language paradigms, and demonstrate how culturally responsive practices can be achieved in different linguistic contexts. Method: Examples of different approaches used to inform accurate diagnosis of SSD in 2- to 8-year-old multilingual children are described. The approaches used included (a) considering adult speech models, (b) completing validation studies, and (c) streamlining evidence-informed techniques. These methods were applied across four different language paradigms in countries within the Global North and Global South (e.g., Jamaican Creole-English, Jamaica; Vietnamese-English, Australia; French and additional languages, Belgium; Icelandic-Polish, Iceland). The culturally responsive nature of approaches in each cultural/linguistic setting is highlighted as well as the broader applicability of these approaches. Results: Findings related to dialect-specific features, successful validation of tools to describe functional speech intelligibility and production accuracy, and the utility of different techniques applied in the diagnosis of SSD are outlined. Conclusions: Culturally responsive methods offer a useful framework for guiding SLPs' diagnostic practices. However, successful application of these practices is best operationalized at a local level in response to the linguistic, cultural, and geographic context.