Despite the fact that bilingual language processing generally takes place in complex natural environments with multiple simultaneous modes of input, laboratory studies of bilingualism rarely consider the multimodal nature of bilingual language comprehension. For bilingual as well as monolingual listeners, multimodal input includes both linguistic input (such as the phonological and orthographic forms of a word), as well as non-linguistic input (such as seeing the face of the speaker or the objects in the listener’s immediate surrounding environment). While the interaction between phonology and orthography has received consideration in psycholinguistic studies of bilingual language processing, research on cross-modal audio-visual sensory integration in bilinguals is more limited. In general, audio-visual integration in bilinguals has yet to receive careful consideration in the literature. The objective of this chapter is to contribute to the understanding of how bilingual language processing is impacted by multimodal integration and audio-visual interaction. To accomplish this goal, two bodies of literature are considered. The first incorporates paradigms that consider multimodal integration of auditory and visual input during language comprehension and discusses them within the context of bilingualism. The second focuses on evidence suggesting that orthographic and phonological information interact during bilingual spoken and written language comprehension. The chapter also reviews existing models of bilingual language processing that may be able to account for audio-visual interaction, and draws implications for representation in the bilingual mental lexicon.