This study discovered that limited health literacy was associated with greater difficulty in reconciling prescribed medications. Investigators conducted interviews and literacy assessments for 119 patients and found poor agreement between antihypertensive medications in the medical record and those named by patients. The authors support greater attention to medication reconciliation in the ambulatory setting and improved strategies to address health literacy barriers. An AHRQ WebM&M commentary discusses an error attributed to poor medication reconciliation and shares tips on designing a process in the hospital setting.