The strong association between music and speech has been supported by recent research focusing on musicians' superior abilities in second language learning and neural encoding of foreign speech sounds. However, evidence for a double association—the influence of linguistic background on music pitch processing and disorders—remains elusive. Because languages differ in their usage of elements (e.g., pitch) that are also essential for music, a unique opportunity for examining such language-to-music associations comes from a cross-cultural (linguistic) comparison of congenital amusia, a neurogenetic disorder affecting the music (pitch and rhythm) processing of about 5% of the Western population. In the present study, two populations (Hong Kong and Canada) were compared. One spoke a tone language in which differences in voice pitch correspond to differences in word meaning (in Hong Kong Cantonese, /si/ means ‘teacher’ and ‘to try’ when spoken in a high and mid pitch pattern, respectively). Using the On-line Identification Test of Congenital Amusia, we found Cantonese speakers as a group tend to show enhanced pitch perception ability compared to speakers of Canadian French and English (non-tone languages). This enhanced ability occurs in the absence of differences in rhythmic perception and persists even after relevant factors such as musical background and age were controlled. Following a common definition of amusia (5% of the population), we found Hong Kong pitch amusics also show enhanced pitch abilities relative to their Canadian counterparts. These findings not only provide critical evidence for a double association of music and speech, but also argue for the reconceptualization of communicative disorders within a cultural framework. Along with recent studies documenting cultural differences in visual perception, our auditory evidence challenges the common assumption of universality of basic mental processes and speaks to the domain generality of culture-to-perception influences.