The Mini-Mental State Exam (MMSE) is commonly used to screen cognitive function in a clinical setting. The measure has been published in over 50 languages; however, the validity and reliability of the MMSE has yet to be assessed with the culturally Deaf elderly population. Participants consisted of 117 Deaf senior citizens, aged 55-89 (M = 69.44, SD = 8.55). Demographic information, including state of residence, age, and history of depression, head injury, and dementia diagnoses, were collected. A standard form of the MMSE was used with modification of test administration and stimuli including translation of English test items into a sign-based form and alteration of two items in order to make them culturally and linguistically appropriate. Significant correlations were observed between overall test score and education level (r = .23, p = .01) as well as test score and age (r = -.33, p < .001). Patterns of responses were analyzed and revealed several items that were problematic and yielded a fewer correct responses. These results indicate that clinicians need to be aware of cultural and linguistic factors associated with the deaf population that may impact test performance and clinical interpretation of test results. On the basis of these data, there is an increased risk of false positives obtained when using this measure. Further research is needed to validate the use of this measure with the culturally Deaf population.