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Background Communication in a family’s primary language can support safe care. Vital steps within the care delivery process are contingent on successful communication, including reporting symptoms, clinical decision-making, informed consent, discharge communication and follow-up coordination. The importance of effective information exchange is particularly pronounced in paediatric emergency care, and complex interactions may arise as parents or carers advocate on behalf of children. This scoping review aimed to identify and map existing research indicating where along the care journey communication-related risks for safety lie during paediatric emergency care and what strategies exist to mitigate them.Methods We searched MEDLINE, Embase, CINAHL, Scopus, Web of Science and Cochrane Library for studies which examined the influence of language barriers on patient safety in paediatric emergency care as well as studies that evaluated interventions. Bibliographic database searches were executed on 18 December 2024; retrieved records were independently screened by two authors at title and abstract level followed by full text level. Data on study objectives, population characteristics, study design and their key findings were extracted.Results 1578 articles were identified, of which 33 were included and mapped according to (i) studies reporting safety risks linked to language barriers in paediatric emergency care (n=24) and (ii) existing interventions designed to mitigate these risks (n=9). Studies highlighted that language barriers can influence safety at multiple stages of the emergency care pathway, with discharge most frequently reported as a point of risk for paediatric patient safety. Interventions focused primarily on usage, uptake and documentation of professional interpreter services.Conclusion Addressing misunderstandings around follow-up and home-care advice during medical safety netting are priority areas for intervention. Future research should involve carer and clinical perspectives in exploring whether technology-enabled tools, including artificial intelligence, can safely mitigate language barriers in these situations.