The often-cited back translation procedure used for the translation of research instruments has not been consistently described in cross-cultural literature. Translation errors resulting in conceptually dissimilar instruments can compromise comparisons of cross-cultural health initiatives. This report describes a five-step translation procedure and equivalence and reliability testing process used to develop the High School Questionnaire: Profile of Experiences (HSQ) in Mandarin. Each step of the translation process provided additional information and detected discrepancies between the English and Mandarin versions of the HSQ. Issues related to grammatical translation, cultural usage and experience, syntax, and concept interpretation were exposed by the translation process. The procedures used in this 18-month study were rigorous enough to create an instrument that was both linguistically appropriate and culturally relevant.