The purpose of this study was to examine the relationship between the quality of childcare and experience with otitis media (middle ear disease) as they relate to children's early naturalistic language development. Sixty children were followed longitudinally from childcare entry in the first year of life until three years of age. Half the children were in higher quality childcare and half in lower quality childcare, but parent demographics, like education and income, were not associated with the quality of the childcare. Experience with otitis media was monitored weekly in the childcare setting. Naturalistic language samples were collected at 18, 24, and 36 months of age and coded for a variety of syntactic, morphological and semantic markers of language development. Results suggested that children in higher quality care were more advanced on most of the measures of language, especially at 24 and 36 months of age. Children in lower quality care became progressively further behind the children in higher quality care on all language measures. This was especially true for vocabulary, with children in higher quality care having double the number of different words by 36 months as compared to the children in lower quality care. There were no main effects or interactions for experience with otitis media over the first three years.