The prevalence of weight problems among youth in general and youth in out-of-home care has been well documented; however, the prevalence of obesity/overweight among youth with high-incidence disabilities in more restrictive settings, such as residential care, has not been assessed. The purpose of the present study was to evaluate the prevalence of weight problems in 245 youth with learning disabilities or emotional disturbance at entrance to residential care. Youth intake files were examined to evaluate the association between youth demographic characteristics, medical conditions, prior placements and placement settings, medication usage, and internalizing and externalizing behavioral problems and clinical weight problems. Findings revealed that over one half of the youth were overweight or obese (50.6%), and weight problems were associated with gender, medical conditions, and age. Study limitations, future research efforts, and treatment implications are discussed.