We compared depressive symptomatology and its sociocultural context across a Peruvian sample of 93 and a US sample of 64 adult depressive patients. The design involved the interview and evaluation of both groups by a bilingual investigator using Spanish- and English-language versions of the same assessment instruments. A basic commonality of core depressive symptoms and signs was found across samples, which also had similar levels of overall depressive severity. However, more complaints and higher scores on somatic symptoms and daily fluctuation of depression were seen in the Peruvian group, while the US group had higher scores on suicidal manifestations.