Students with disabilities are at increased risk of experiencing mental health difficulties, but may not be recognised as an at-risk population in the design of school-based prevention and intervention efforts. Understanding the link between disability and mental health is important for school psychologists and guidance counsellors, teachers, and special education personnel who are in a position to provide targeted opportunities for social and emotional learning and to ameliorate the potential for marginalisation and isolation. This article reviews research related to mental health in students with disabilities, with a focus on understanding potential pathways between disability and mental health difficulties and examining the evidence for effective universal and targeted interventions. The research reviewed highlights the need for mental health promotion in schools to incorporate targeted approaches for at-risk students within the context of universal, whole-school approaches, and in particular to consider the mental health needs of students with disabilities.