Children who are deaf and hard of hearing (DHH) and born to hearing parents have delays in their social-cognitive development and in particular in their theory of mind (ToM). These delays are often attributed to the difficulties they encounter in acquiring age-appropriate linguistic and communicative skills. The present study asks whether this developmental delay extends to problems with understanding pretend emotions and if linguistic difficulties are related to this area. A total of 173 children (82 DHH and 91 hearing) between 3 and 8 years of age received a set of emotion and language measures. Results showed that children who are DHH were delayed in understanding pretend emotions, and this was strongly related to their difficulties with expressive vocabulary and pragmatics. In summary, children who are DHH and have experienced reduced access to language and communicative interaction have a restricted understanding of the communicative intentions of emotional expressions. These delays may have implications for their social relationships with surrounding family and other children.