Race has yet to be discussed as a significant factor in the field of speech-language pathology. Race is often conflated with nonmainstream dialects and discussed in purely linguistic terms. However, the terms we use to describe dialects are highly racialized, centering white mainstream norms and treating nonmainstream varieties of English as “different” and, therefore, inferior. Hierarchical thinking about language contributes to the misdiagnosis in Black and other communities of color because racialized language ideologies have been left unstated. This chapter demonstrates through a critical race theory approach how structural racism shapes the field's conceptualization of language and competence. Using an intersectional lens in particular, this chapter discusses race, disability, and language ideology as systems of domination that compound the effects of racism for communities of color. CRT is then used to reveal, critique, and intervene on the historically embedded racist structures that continue to manifest in speech-language pathology research, teaching, and practice today.