The authors examined the role of early adverse experiences, mental health problems, and disabilities in the prediction of juvenile delinquency and recidivism, using a matched-control group design. The delinquent group comprised 99,602 youth, born between 1981 and 1988, whose cases had been processed by the South Carolina Department of Juvenile Justice. Records of 99,602 controls, matched by age, race, and gender were drawn from the records of the South Carolina Department of Education. Data on Child Protective Services, foster care, mental health referrals, and diagnoses as well as information about eligibility for free/reduced-price lunch were obtained from the South Carolina Budget and Control Board, Office of Research and Statistics. Logistic regression analyses showed that parental maltreatment and foster care made unique contributions to the prediction of membership in a delinquent sample. Presence of a public school classification of learning disability or emotional/behavioral disorder was also predictive of delinquent outcomes. A prearrest Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnosis relating to aggressive behavior (e.g., conduct disorder) was the strongest predictor of delinquency. Analyses conducted on the delinquent sample to predict recidivism showed a similar pattern, with an early mental health diagnosis of an aggressive disorder the strongest predictor of recidivism.