Objective. To study the perceptions that advanced pharmacy practice experience (APPE) students whose first or best language is not English have regarding their writing skills and the APPE writing experience, and to study the perceptions and experiences that APPE preceptors have about the writing skills of students whose first or best language is not English. Methods. Twenty-one APPE students representing 3 pharmacy schools were individually interviewed using 20 guided questions to elicit information about, but not limited to writing, grammar, vocabulary, and spelling skills, and the APPE. Additionally, 101 preceptors representing 48 pharmacy schools completed a 9-item Likert-type survey instrument to rate students' grammar, writing, vocabulary, spelling skills, and areas related to APPE writing, and a tenth open-ended item asking them to describe how writing strengths and weaknesses help or hinder the APPE experience. Results. The students indicated the need to improve writing and writing-related skills, such as reading, paraphrasing, and summarizing. They made recommendations to future APPE students and pharmacy schools on how to prepare students for the writing tasks encountered in APPEs. The preceptors indicated the writing skills of APPE students whose first or best language was not English ranged from "weak'' to "needs improvement'' to "dangerous.'' Additionally, the subject of lack of good verbal communication skills and their relation to written communication skills was raised by students and preceptors. Conclusion. Both students and APPE preceptors indicated that the APPE students lacked essential and acceptable writing skills.