Objective: The present study examined lifetime psychiatric disorders and current emotional and behavioral problems of 8- to 12-year-old children living with drug-abusing (DA) fathers compared to children living in demographically matched homes with alcohol-abusing (AA) or non-substance-abusing fathers. Method: Children's lifetime psychiatric diagnoses were determined using the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime Version. In addition, both parents completed the Pediatric Symptom Checklist. Substance-abusing fathers were recruited from an outpatient treatment program. Results: Children who lived with DA fathers were more likely to have a lifetime psychiatric diagnosis (i.e., 53% versus 25% in AA homes and 10% in non-substance-abusing homes). Compared to children in the other groups, children in DA homes were more than twice as likely to exhibit clinical levels of behavioral symptoms. Conclusions: Children living with DA fathers were more likely to experience a lifetime psychiatric disorder and more negative behaviors compared to children living with an AA father or non-substance-abusing parents. J. Am. Acad. Child Adolesc. Psychiatry, 2004;43(5):621-628. Key Words: children's psychiatric disorders, substance-dependent fathers.