Introduction: Treatment limitation discussions often take place between intensive care clinicians and families of patients from culturally diverse backgrounds. Objective: To explore practices of treatment limitation discussions with culturally diverse families. Methods: Using a retrospective medical record audit, data were collected from all patients who died during 2018 in four intensive care units in Melbourne. Data are presented using descriptive statistics and qualitative progress note entries. Results: From 430 adult deceased patients, 49.3% (n=212) patients were born overseas, 57.4% (n=247) identified with a religion, and 14.9% (n=64) spoke a language other than English, yet professional interpreters were only used in 5.6% (n=24) of family meetings. In some cases, there was evidence that family declined interpreter use, but in other cases, family members or clinicians were used to translate key information. There was evidence of nurse participation in meetings to discuss treatment limitations for 49.8% (n=123) of culturally diverse patients; however, in some meetings, nurse involvement was for translation only. Progress note entries indicated that some culturally diverse families had a strong belief not to withdraw treatment, therefore treatment limitation discussions were sometimes delayed until closer to death to allow family time to process the severity of illness. Conclusions: Best practice guidelines recommend professional interpreters are used to ensure families are supported to contribute to care planning. Therefore, further research is necessary to explore barriers to interpreter use, and the potential impact on the accuracy of communication; and barriers to nurses’ active participation in treatment limitation discussions and the impact this has on patient and family care is recommended. Further, consideration of the implications of delaying treatment limitation discussions in culturally diverse families is essential to ensure culturally appropriate care.