This paper studied music in 14 children and adolescents with Williams-Beuren syndrome (WBS), a multi-system neurodevelopmental disorder, and 14 age-matched controls. Five aspects of music were tested. There were two tests of core music domains, pitch discrimination and rhythm discrimination. There were two tests of musical expressiveness, melodic imagery and phrasing. There was one test of musical interpretation, the ability to identify the emotional resonance of a musical excerpt. Music scores were analyzed by means of logistic regressions that modeled outcome (higher or lower music scores) as a function of group membership (WBS or Control) and cognitive age. Compared to age peers, children with WBS had similar levels of musical expressiveness, but were less able to discriminate pitch and rhythm, or to attach a semantic interpretation to emotion in music. Music skill did not vary with cognitive age. Musical strength in individuals with WBS involves not so much formal analytic skill in pitch and rhythm discrimination as a strong engagement with music as a means of expression, play, and, perhaps, improvisation.