Fragile X syndrome (FXS) is the most common inherited cause of mental retardation. It is an X-linked condition which affects both males and females. Patients with Fragile X syndrome have cognitive, social, behavioral and physical problems which result in language and speech problems.The present study was conducted on 25 males ranged from 4-18 years with Fragile X syndrome based on DNA analysis. They were selected from the outpatient clinic of Children with Special Needs in the National Research Centre (NRC). A control group (25 males) matched for the same chronological age was selected from the outpatient clinic of pediatrics and internal medicine in the National Research Centre (NRC). Speech and language assessment were done for all participants using Standardized Arabic Language test and articulation test. Our results showed significant delay in speech and language in both children and adolescent males with Fragile X syndrome. Relative strengths in semantics compared to syntax and pragmatics were observed in all cases. Expressive language was significantly affected in Fragile X patients more than receptive language. The cognitive level and autistic features of the patients played an important role in language development. Characteristic speech patterns were observed among males with FXS included rapid and fluctuating rate, dysfluent and perseverative speech. Phonological difficulties were common. In conclusion, language and speech assessment have important clinical implications for developing specific speech and language intervention programs for those patients.