Accommodations are intended to address student academic and behavioral deficits by reducing obstacles that impede learning and accurately measuring skills. There is limited research, however, pertaining to the types of accommodations students receive and their selection, particularly among those with emotional and behavioral problems. This is a significant concern for secondary age students who spend the majority of their day in regular education settings and must participate in high-stakes testing. We examined types of accommodations provided to 222 secondary students with emotional and behavioral problems, their use (i.e., classroom or standardized assessments), and variables related to their selection. Analyses indicated (a) students received a wide array of accommodations with some differences depending on disability type, (b) more accommodations were provided in the classroom than on standardized testing, (c) few demographic variables were associated with type or number of accommodations, and (d) with a single exception, academic and behavioral functioning did not explain type of accommodation received. The findings suggest that accommodation selection is highly imprecise and point to the critical need for further research in this area.