This study examined interpersonal competence configurations in a sample of 315 fifth-grade students (170 girls and 145 boys) from 8 elementary schools in the Appalachian region. Teachers completed the Interpersonal Competence Scale-Teacher (ICS-T) for each student. The ICS-T consists of 18 7-point Likert scales to assess academic achievement, aggression, internalizing behavior, popularity, social skills, and athletic ability/attractiveness. Teachers also completed scales pertaining to social adaptation. Students completed peer behavioral assessments, sociometric surveys, and social network surveys. Nearly 40% of students were in high-competence configurations characterized by high teacher ratings on academic, behavioral, and social adjustment. These configurations were associated with high end-of-year grades and standardized achievement test scores and with positive peer relationships. In contrast, 16% of girls and 27% of boys were in high-risk configurations characterized by high teacher ratings of academic, behavioral, and social difficulties. These configurations were associated with low end-of-year grades and standardized test scores and with social and behavioral difficulties that are predictive of later adjustment problems. We also identified moderate-risk configurations that tended to fall between high-competence and high-risk configurations in terms of their relation to academic achievement and peer relations. Implications for interventions are discussed. (Contains 13 tables.)