Speech-language pathologists (SLPs) are increasingly asked to assess the pronunciation of bilingual individuals, yet many report feeling underprepared and lacking confidence in their ability to do so efficiently. Meanwhile, second-language (L2) teachers can be involved in teaching bilingual individuals with a speech-sound disorder (SSD). This article examines key issues in L2 pronunciation assessment and highlights the need for a dynamic view of communication efficiency. We aim to bridge the gap between SLP clinical practice and L2 pronunciation research by clarifying terminological differences and their implications in assessment. After outlining the roles of SLPs in relation to L2 pronunciation, we provide an overview of the profiles and development of bilingual individuals. Then, we discuss how pronunciation is conceptualized in both fields, focusing on the dimensions of intelligibility, comprehensibility, and accentedness. We then introduce our Integrated Model of Communication Efficiency, which accounts for key dimensions and factors shaping L2 speech in typically developing bilinguals and those with an SSD. We conclude with practical recommendations to strengthen L2 pronunciation assessment across clinical and instructional contexts, thereby supporting more accurate identification of speech disorders in bilingual populations.