Given the ongoing debate over whether giftedness is associated with mental health disorders, there is a great need to highlight and compare results from the most methodologically rigorous studies. Surprisingly, the vast majority of literature reviews and background sections of research articles include studies that do not directly compare gifted and nongifted youth. Furthermore, almost no attention has been paid to how differences in the definitions of giftedness or mental health outcomes of interest affect the interpretation and comparison of studies. The authors apply an epidemiologic perspective for thinking about these issues, highlight many of the challenges of studying this population, and present results from meta-analyses that include the most methodologically rigorous studies comparing rates of depression, bipolar disorder, anxiety, suicide ideation, and attention deficit hyperactivity disorder (ADHD) between gifted and nongifted youth. They conclude with recommendations to strengthen research in this area. Putting the research to use: Through this review we sought to provide concrete recommendations to strengthen future research on the mental health of gifted children. Most notably, future studies should assess large, population-based cohorts that include both gifted and nongifted individuals. Researchers should also move toward describing their study population according to their specific aptitudes, talents, skills or abilities, rather than using the general term "gifted". Thinking more specifically about these relationships will not only help us to understand the association between giftedness and mental health, but will also increase the potential to effectively shape programs and policies for gifted youth, focusing resources on the most vulnerable. (Contains 2 figures and 1 table.)