Background: There are no studies of the distinct trajectories of children's psychological distress over the first year after a destructive natural disaster and the determinants of these trajectories. Objective: We examined these issues using an existing dataset of children exposed to Hurricane Andrew, one of the most devastating natural disasters in US history. Methods: At 3-months postdisaster, 568 children (55% girls; grades 3-5) residing in areas most directly affected by the hurricane completed measures of hurricane exposure and stressors, social support, coping, and general anxiety. Children also reported major life events occurring since the hurricane (at 7-months) and posttraumatic stress (PTS) symptoms at 3-, 7-, and 10-months postdisaster. Results: Latent growth mixture modeling identified three trajectories of PTS reactions: resilient (37%), recovering (43%), and chronic distress (20%). Predictors of the trajectories were examined. Odds ratios indicated that, compared to the resilient trajectory, girls were more likely to be in the recovering and chronically distressed trajectories, as were children reporting higher anxiety and greater use of coping strategies that reflected poor emotion regulation. Compared to the recovering trajectory, children in the chronically distressed trajectory had greater odds of reporting high anxiety, less social support, more intervening life events, and greater use of poor emotion regulation strategies. Conclusions: Hurricane exposure may be less effective in identifying children who develop chronic postdisaster distress than other child (anxiety, coping) and contextual variables (social support, life events). Effective screening after disasters is critical for identifying youth most in need of limited clinical resources.