This study examined whether siblings of children with disabilities have increased mental health problems, behavioral difficulties, or greater mental health service use as compared to siblings of children without disabilities. Data come from the 2006 National Health Interview Survey. Propensity score matching was used to complete the analysis. Twelve siblings and family demographic characteristics were used to create the propensity score. Hierarchical greedy matching without replacement was used to match siblings. Prior to the match, significant differences were present between sibling groups on all outcome variables. After the match, no significant differences remained. Effect sizes were compared and were smaller postmatch for all the three measured outcomes. Findings suggest that differences in siblings' mental health are not likely due to the presence of a brother or sister with a disability, but it is more likely that the co-occurring risk factors (e.g., living in a lower income household) contribute to the observed sibling differences.