Background: Our main purpose was to compare the lexical development of Spanish children with Down syndrome (DS) and children with typical development (TD) to investigate the relationship between cognitive and vocabulary development in comprehension and oral and gestural production. Method: Participants were 186 children with DS and 186 children with TD, with a mental age (MA) of 8-29 months and matched on gender and MA. Information about vocabulary was obtained using a new Spanish adaptation of the MacArthur-Bates CDI for children with DS. Results: No significant differences in oral production were found. Lexical comprehension and gestural production of children with DS were superior. Similar to children with TD, gestural production in children with DS decreased as oral production increased. Conclusion: Our study provides evidence to support that lexical comprehension and gesture production are strengths in children with DS. With respect to oral production, our results do not support a specific dissociation between cognitive and lexical development. (Contains 2 tables and 2 figures.)