Child Behavior Checklists completed by parents of 50 children of each sex at each age from 4 to 16 seen in 28 American and 21 Dutch mental health services (N = 2,600) were examined. Analyses controlling for sex, age, and socioeconomic status showed somewhat higher total problem scores for American than Dutch children, with a mean of 57.27 versus 53.18 on a scale ranging from 0 to 240. This nationality difference accounted for less than 1% of the variance in total scores. American children obtained higher scores on more externalizing items than Dutch children. Small but significant differences in total, externalizing, and internalizing problems found between the two samples may reflect nationality differences in referral patterns. Competence scores were significantly higher for American than Dutch referred children, but did not differ as much as in comparable normative samples. Competence scores may reflect cultural differences more than problem scores do.