Objective: The percentage of children with clinical levels of internalizing and externalizing problems before and after maternal death from acquired immunodeficiency syndrome was contrasted with two comparison groups: children whose mothers were human immunodeficiency virus infected but continued to live and children whose mothers were not infected. Method: One hundred five 6- to 11-year-old African-American children from New Orleans and their mothers or caregivers participated. Mothers and caregivers completed the Child Behavior Checklist. Results: The findings indicated that, relative to those in one of the two control groups, more children in the orphans group had clinical levels of internalizing and externalizing problems before their mother's death and clinical levels of internalizing problems 2 years after her death. No differences emerged at 6 months after the mother's death. Conclusions: The differences that emerged and the high percentage of children in the orphans group in the borderline clinical or clinical range (52%-73% across the three assessments) indicate the importance of intervention efforts for these children beginning before the mother's death and continuing after her death. J. Am. Acad. Child Adolesc. Psychiatry, 2005;44(6):585-591. Key Words: orphans, acquired immunodeficiency syndrome, problem behaviors.