We identified individuals with deficits in musical pitch recognition by screening a large random population using the Distorted Tunes Test (DTT), and enrolled individuals who had DTT scores in the lowest 10th percentile, classified as tune deaf. We examined phonological processing abilities in 35 tune deaf and 34 normal control individuals. Eight different tests of phonological processing, including auditory word discrimination, syllable segmentation, and the Comprehensive Test of Phonological Processing (CTOPP) were administered to both groups. The tune deaf group displayed lower phonological and phonemic awareness abilities on all measures. Our results indicate that poor performance on the DTT is associated with deficits in processing speech sounds. These findings support the hypothesis that processing of speech sounds and musical sounds share common elements, and that tune deafness may be viewed as a syndromic disorder, frequently accompanied by deficits in a number of aspects of sound processing not specific to music. LEARNING OUTCOMES: The reader will (1) understand the broad range of deficits in phonological perception and processing that accompany deficits in musical pitch recognition, and (2) recognize the possible utility of musical evaluation measures and music-based therapies in the treatment of phonological and other speech disorders.