This study investigated the effects of age and hearing loss on perception of accented speech presented in quiet and noise. The relative importance of alterations in phonetic segments vs. temporal patterns in a carrier phrase with accented speech also was examined. English sentences recorded by a native English speaker and a native Spanish speaker, together with hybrid sentences that varied the native language of the speaker of the carrier phrase and the final target word of the sentence were presented to younger and older listeners with normal hearing and older listeners with hearing loss in quiet and noise. Effects of age and hearing loss were observed in both listening environments, but varied with speaker accent. All groups exhibited lower recognition performance for the final target word spoken by the accented speaker compared to that spoken by the native speaker, indicating that alterations in segmental cues due to accent play a prominent role in intelligibility. Effects of the carrier phrase were minimal. The findings indicate that recognition of accented speech, especially in noise, is a particularly challenging communication task for older people.