Purpose: The relationship between English proficiency and health care outcomes in intensive care has rarely been examined. This study aimed to determine whether being a non-English speaker would predict mortality in a critical care setting. Secondary end points were intensive care unit (ICU) and hospital length of stay. Materials and methods: This is a single-center, retrospective, cohort study of admissions from January 1, 2000 until December 31, 2011 in a tertiary level intensive care setting in Melbourne, Australia. All admissions during the study period were included. Patients without language data were excluded. Of those with multiple admissions, only the first was included. Analysis of 20. 082 ICU admissions was undertaken, of which 19. 059 (94.9 ) were English speakers. Results: After adjusting for confounding variables (age, severity of illness, diagnostic group, year of admission, and socioeconomic status), English-speaking status was independently associated with an increased risk of death (odds ratio, 1.91; 95 confidence interval 1.46-2.49; P <.001). There was no difference in ICU length of stay between groups. Hospital length of stay was shorter for English speakers. Conclusion: Contrary to expectations, this large single-center study shows a consistent relationship between non-English-speaking status and increased survival after admission to ICU.