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Purpose: The objective of this study was to compare children with persistent versus transient preschool language delay on language, academic, and psychosocial outcomes in elementary school. Method: Children with persistent language delay (n = 30), transient language delay (n = 29), and no language delay (controls; n = 163) were identified from a population-based sample of twins. They were compared on language skills, academic achievement, and psychosocial adjustment in kindergarten and Grades 1,3, 4, and 6. Results: Children with persistent language delay continued to show language difficulties throughout elementary school. Furthermore, they had academic difficulties, in numeracy, and psychosocial difficulties (attention-deficit/hyperactivity disorder behaviors, externalizing behaviors, peer difficulties) from Grade 1 to Grade 6. Children with transient language delay did not differ from controls on language and academic performance. However, they showed more externalizing behaviors in kindergarten and peer difficulties in Grade 1 than controls. Conclusion: Difficulties at school age are widespread and enduring in those with persistent early language delay but appear specific to psychosocial adjustment in those with transient language delay., Language skills are central to children's development in promoting school readiness and learning vital to school achievement (Bleses et al., 2016; Dionne et al., 2013; Hoff, 2014; Krajewski & Schneider, [...]