Purpose: The purpose of the present study was to (a) describe and compare the nonword repetition (NWR) performance of preschool-age Spanish-speaking children (3- to 5-year-olds) with and without language impairment (LI) across 2 scoring approaches and (b) to contrast the classification accuracy of a Spanish NWR task when item-level and percentage of phonemes correct (PPC) scoring methods are applied. Method: Forty-four Spanish-speaking children participated. Twenty-one children had LI and 23 had typically developing (TD) language. Children were administered a Spanish NWR task and a standardized Spanish language measure. Results: A developmental pattern in NWR performance was observed, and the children with LI had NWR scores that were significantly lower than those of the TD children. Whereas item-level scoring of NWR items indicated acceptable levels of sensitivity and specificity and suggested positive and negative likelihood ratios, PPC scoring of NWR items resulted in less than desirable levels of sensitivity and adequate specificity. Conclusion: Item-level scoring of 3- to 5-syllable Spanish NWR items may be useful as part of an assessment battery for preschool-age Spanish-speaking children.