Adopted children are disproportionately represented in residential treatment programs in the United States. Adopted children in the United States constitute only 2% to 3% of the U.S population. Nevertheless, they comprise approximately 16.5% of the population in residential care. This descriptive study evaluated a sample of 473 psychological evaluations of adolescents in wilderness and residential treatment centers. Results indicated that, compared with nonadopted youth, adopted youth had greater histories of recent trauma, higher rates of suicidal tendency and biological parents' mental illness, and poorer academic achievement. However, there were no significant differences between adopted and nonadopted youths in terms of defiant behaviors, IQ, substance use/abuse, reasons for referral, impulsivity, anxiety, or depression. Study results suggest that wilderness and residential programs may need to target programmatic elements specifically to meet the special needs of adopted adolescents who comprise a significant percentage of their client population.