Interpreters are expected to have an advanced command of not only the vocabulary and grammar of their working languages, but also the pragmatic norms that speakers of their working languages employ in communicative interactions. The aim of this paper is to explore the perceptions and practices of interpreters in relation to intercultural pragmatics at work in healthcare interactions. The paper employs two theoretical frameworks: the first is based on interpretations of behavior according to speakers discourse-pragmatic features as representative of high or low context cultures (cf. Hall 1976); the second applies CelceMurcia s (2007) more refined notion of communicative competence. The data sample of this paper focuses on cultural-pragmatic features of two linguistic and cultural groups 25 Chinese speakers and 24 English speakers and contrasts their selected responses to five features of Chinese-English interpreted healthcare interactions. Responses from 33 Chinese-English interpreters are matched against those from speakers of the two groups to examine the degree of congruence that interpreters have with the self-reported (para) linguistic behavior of the two groups of speakers, for whom they interpret. This study shows that the self-reported (para) linguistic behavior of both groups is determined by their adoption of a particular approach (doctor vs. patient-centered approach) and other microlevel features (perceived time constraints, different notions of small talk ) that limit elaborate pragmatic enactments. Overarching cultural-pragmatic models based on high (or low ) context communication, or vertical (vs. horizontal ) hierarchical perceptions of role and status appear to have limited application to the data. Instead, local features specific to the healthcare situation co-determine both English and Chinese speakers responses to questions about their use of pragmatics. Findings indicate that interpreters attend to each group s enactment of pragmatic features and, as expert language users, are able to recognize features and components of interactions and their functions to a greater degree than the Chinese and English speakers. (c) 2015, Walter de Gruyter. All rights reserved.