The use of psychotropic interventions to manage the inappropriate behaviors displayed by students who are emotionally disturbed (ED) has continued to increase over the past several decades. To date, few studies have investigated the use of psychotropic medications among students with ED placed in the most restrictive educational settings (i.e., residential facilities). For this study, medication records from 137 students placed in three nonpublic residential schools were reviewed. This survey found that medication rates varied from 65% to 94%, with an overall medication rate of 76% among students placed in residential care. Other findings of interest included (a) Caucasian students were more likely to receive medication therapy than their African American or Hispanic peers, and (b) students placed in a residential center specializing in treating students with a history of substance abuse were less likely to receive medication therapy. (Contains 3 tables.)