Low language ability has profound implications for education outcomes, employment opportunities, health literacy, parenting, and social inequalities. However, little is known about the economic impact of children experiencing low language on health, education and employment systems, specifically for children with low language that persists over time. This book chapter examines the impact of low language on service use and costs from early childhood to adolescence (4–13 years) using data from a longitudinal community-based Australian study, the Early Language in Victoria Study. Patterns of different service use and costs associated with low language from 4’13 years were described. Under-servicing (child had identified needs but did not access services) and over-servicing (child used services but had no identified needs) were examined. Key predictors for the use of services associated with low language, such as parental concern about their child’s speech and language and financial barriers, were also explored. The chapter concludes with a discussion about the findings, their clinical and policy implications, and future directions for research and practice, together with the strengths and limitations of the study.