This paper presents cross-cultural comparisons on definitions, prevalence, and outcomes of students with emotional-behavior disorders (EBD). In addition, the paper addresses the concern of disproportionality and the need for teachers of students with behavior problems to be culturally responsive to perceived inappropriate behaviors. A review of literature revealed that most Western countries recognize EBD as a disability and provide special services to students with this label, while developing countries continue to be more likely to address more visible disabilities. The review of literature modestly suggests that (1) labeling results in appropriate intervention, positive outcomes, and accountability data, (2) teachers must recognize how their beliefs on behavior are mediated by a number of factors (including ethnicity, socioeconomic status, and gender), (3) inclusive practices must be implemented responsibly in the context of high accountability reform, and (4) preventive approaches to EBD must begin early in the classroom with culturally competent teachers.