Emergent bilingual (EB) students navigate the dual demands of acquiring a new language while engaging with complex academic content—particularly in mathematics, where language access is often assumed, rather than supported. This chapter examines how language development intersects with mathematical learning and highlights disparities that often emerge not from conceptual difficulty but from linguistic barriers embedded in instruction and assessment. We explore the role of culturally and linguistically responsive instruction in addressing these inequities, emphasizing the importance of distinguishing between language acquisition and math difficulty. Drawing from current research and practice, we present a framework for implementing culturally adapted interventions that integrate evidence-based instructional strategies with students’ cultural and linguistic knowledge. We provide guidance on assessment practices, vocabulary development, and instructional scaffolding to support EB students, particularly those at risk for or with identified math difficulties. A case study illustrates the application of these strategies in real-world settings, and we discuss implications for teacher preparation and system-wide equity efforts. This chapter serves as a practical resource for educators committed to fostering inclusive, high-quality mathematics instruction for linguistically and culturally diverse learners.