As the current interest in the economic evaluation of health care interventions increases, both cost-effectiveness analysis and cost/benefit analysis show potential for use in the evaluation of language access services. A case study is used to illustrate the different perspectives in economic evaluation, the appropriateness and limitations of various methods, and a limited number of identifiable “costs” and “consequences” in health interpreter programs. There are significant challenges in conducting economic evaluations that will identify more than the partial and immediate institutional costs of language barriers and interpretation services. The methodology in the program studied presents an opportunity for promoting language access services. However, it is essential that advocates of such programs become familiar with the principles of economic evaluation, in order to utilise the potential of the methodology and to critique poorly designed studies. A comprehensive evaluation process must also include effectiveness evaluation, and an analysis of ethical and legal responsibilities.