To examine the implications of custodial grandparent care, we compared the material hardship, mental health, and physical well-being of custodial grandmothers (n=90) and biological mothers (n=1,462) using data from Welfare, Children, and Families: A Three-City Study. Custodial grandmothers reported significantly more physical health problems but less psychological distress than mothers. Younger grandmothers and grandmothers who sought out more social support were the most disabled and financially strained. Implications for policy and practice addressing the needs of grandmothers raising grandchildren are discussed.