Emotional Disturbance (ED) is one category under which a student can be evaluated and determined eligible to receive special education and related services. Students who experience ED are at greater risk for a host of negative long-term outcomes that include poor social, behavioral, and academic achievement in school, which in turn may impact graduation and postsecondary outcomes. In this article, we provide historical context and current data to highlight contemporary issues surrounding the needs and education of students with ED. Specifically, we present child-count data and descriptions of students that are currently served in the ED category. We provide information about the frequency and types of disciplinary events students with ED experience and discuss associated secondary and postsecondary outcomes. We summarize positive achievements and continued challenges within the field. Finally, derived from the ongoing unmet needs of students with and at risk for ED, we recommend (a) revision of the current Individuals with Disabilities Education Improvement Act terminology and eligibility criteria to a more comprehensive education-based definition; (b) regular universal screening for signs of social, emotional, and/or behavioral problems; (c) use of multitiered systems of support that offer preventive interventions to address the social, emotional, and behavioral needs of all students, particularly when they first emerge; and (d) integrated delivery models that allow greater access to related services to enhance the benefits of special education for students with ED.