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As family disruption, violence, and the decline of community become more common, an ever-growing number of children are exposed to psychological and social stressors that can lead to serious emotional problems. For many children emotional problems can interfere with normal psychological and social development and can have serious long-term effects. In this study data from a large national survey are used to examine patterns of emotional and physical comorbidity and the uses of general medical and mental health services by children ages 4 to 11. Results indicate that emotional problems are common among children with physical illnesses and that emotional problems increase general medical care use. Emotional problems are clearly exacerbated by factors associated with poverty. The data also show that a larger proportion of children in single-parent than in two-parent families experience emotional problems and use mental health services. We discuss the implications of these findings for general pediatric practice.