A non-English primary language (Non-EPL) is a recognised risk factor for inadequate bowel preparation, which can lead to delayed procedures, repeat colonoscopies, and increased healthcare costs. New South Wales (NSW) has the highest population of Non-EPL, endoscopy units must implement effective multilingual strategies to maintain care standards. Our centre has adopted a proactive approach, using interpreter services, translated resources, and language-specific clinics. This study aimed to assess the effectiveness of these interventions by comparing bowel preparation quality and inadequate colonoscopy rates between Non-EPL and English primary language (EPL) patients. Methodology: A retrospective review of elective colonoscopies performed from January to June 2025 was conducted at a high-volume, culturally diverse Sydney hospital. The primary outcome was the rate of inadequate bowel preparation, defined as a Boston Bowel Preparation Score (BBPS) <6. Secondary outcomes included median BBPS and rates of deferred or repeated colonoscopies. Outcomes were compared between EPL and Non-EPL cohorts. Results: A total of 720 elective colonoscopies were analysed. Twenty-nine patients (4%) had inadequate preparation (BBPS <6); 55% were EPL and 45% Non-EPL. There was no statistically significant difference in preparation quality, with both groups achieving a median BBPS of 8. Conclusion: Contrary to previous studies, Non-EPL status was not associated with poorer bowel preparation. Our centre’s inadequate preparation rate (4%) meets GESA’s benchmark (<10%) and aligns with high-performing centres (<5%), likely reflecting the effectiveness of our multilingual communication strategies.