Clinical trials form a critical component of scientific advancement and lead to subsequent improvements in patient care. There are multiple challenges for equitable clinical trial enrollment, among them social determinants of health, such as non-English language preference (NELP). NELP has a wide-ranging impact on patients across various medical settings that impedes access to clinical trials and subspecialty care. Patients with NELP and cardiovascular disease face higher rates of readmissions and emergency department visits.^1,2 Additionally, lack of English language proficiency has been associated with higher rates of adverse events and medical errors, worse end-of-life care, and lower rates of patient satisfaction.^3,4 These disparities in care are rooted in systemic barriers, such as a lack of accessible interpreter services, and intersect with socioeconomic status, sex, race, and ethnicity. While there are increasing efforts to improve reportability and inclusion of racially and ethnically diverse populations in clinical trials, representation of patients with NELP in clinical trials remains difficult to assess, as it is seldom reported. In cardiology, to our knowledge, no prior studies have evaluated language diversity among clinical trial participants. Herein, we describe the current landscape and barriers to enrollment of patients with NELP in cardiology clinical trials.