This study examined the relationship between child language skills and parent and child gestures of 58 youths with and without an autism spectrum disorder (ASD) diagnosis. Frequencies and rates of total gesture use as well as five categories of gestures (deictic, conventional, beat, iconic, and metaphoric) were reliably coded during the collaborative Tower of Hanoi task. Children with ASD had lower Peabody Picture Vocabulary Test scores and gestured less and at lower rates compared to typically developing children. Gesture use was unrelated to vocabulary for typically developing children, but positively associated with vocabulary for those with ASD. Demographic correlates of gesturing differed by group. Gesture may be a point of communication intervention for families with children with ASD.