The purpose of this article was to discuss the challenges of instrument translation, using the translation of the Medical Outcomes Study Social Support Survey into Chinese as an example. Brislin's model of translation, which highlights the need for forward and backward translation, was used. Major considerations in conducting translation, and the strategies used to overcome the challenges arising from cultural and linguistic differences between the source and target languages, were discussed. Examples were used to illustrate how difficulties, such as maintenance of the original intent of the questionnaire, maximization of the cultural relevancy of the concept in question, and enhancement of the comprehensibility of the translated questionnaire, were handled. The importance of literal and cultural adaptation of a developed instrument, rather than its simple word translation in the maintenance of an equivalent translation is highlighted.