To date, few studies have described speech, language, or hearing disorders or services in South America. This investigation was conducted as an examination of nearly 5,000 clinical records from a 3-year period in a university speech, hearing, and language clinic at the Universidade Tuiuti do Paraná in Curitiba, Brazil. The findings document that hearing loss from middle ear and sensorineural pathologies was the predominant communication disorder (N=4,728). Speech and language disorders from a variety of causes were diagnosed and treated in a small percentage of the client population (n=194). This is in sharp contrast to many of the client populations in many speech, language, and hearing clinics in the United States. However, the larger numbers of hearing disorders may be explained in part by a traditional emphasis on audiology in Brazil, significant health risks to hearing among the poor, and a more recent emergence of speech-language pathology training in Brazilian universities.