The mental health needs of school principals have been consistently overlooked in the field of educational leadership and in the preparation and professional development of principals. This mixed-method study compares rates of burnout and secondary trauma of principals in one urban school district along the U.S.-Mexico border with other human-service professionals and provides examples of how two principals experienced burnout and secondary trauma. Most principals reported low rates of burnout and secondary trauma, but follow-up interviews with two newer principals revealed significant exposure to trauma. Findings inform new directions for research and new emphases for preparation.