Brothers and sisters are obligatorily welcomed to the disability community when a person with Down syndrome (DS) is part of the family unit. How they react to such an invitation is the focus of this investigation. Here, we review the most current research on brothers and sisters of persons with DS, and comment on our own experience in facilitating sibling workshops at the local, state, and national levels. The evidence, to date, seems clear: brothers and sisters experience a wide range of emotions, but typically the positive feelings outweigh the negative ones. Further, siblings find rich value in having a family member with DS, and most will assume positions of advocacy at some level in their lives. Recommendations for physicians on how parents can nurture healthy relationships among their children are offered.