Background: In recent reviews of autism spectrum disorder screening tools, the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/FTM) has been recommended for use in lower middle-income countries to promote earlier identification. Aim: The study aim was to culturally adapt and translate the M-CHAT-R/FTM into Northern Sotho, a South African language. Setting: An expert panel was purposively selected for the review and focus group discussion that was conducted within an academic context. Method: The source translation (English) was reviewed by bilingual Northern Sotho-English speech-language therapists who made recommendations for cultural adaptation. A double translation method was used, followed by a multidisciplinary expert panel discussion and a self-completed questionnaire. Results: Holistic review of test, additional remarks and grammar and phrasing were identified as the most prominent themes of the panel discussion, emphasising the equivalence of the target translation. Conclusion: A South African culturally adapted English version of the M-CHAT-R/FTM is now available along with the preliminary Northern Sotho version of the M-CHAT-R/FTM. The two versions can now be confirmed by gathering empirical evidence of reliability and validity.