Background: Systems of care is a family centered, strengths-based service delivery model for treating youth experiencing a serious emotional disturbance. Wraparound is the most common method of service delivery adopted by states and communities as a way to adhere to systems of care philosophy. Objective: The purpose of this study was to evaluate outcomes for children ages 5-18 experiencing serious emotional disturbances who received wraparound in a systems of care community funded through a 6-year federal grant from the Substance Abuse and Mental Health Services Administration, Grant # SM54497-06. This study evaluated the following hypotheses. (1) Youths diagnosed with a SED participating in wraparound services will experience improved mental health symptoms, improved functioning, and improved behavioral and emotional strengths. (2) Caregivers of youths diagnosed with a serious emotional disturbance participating in wraparound services will experience decreased levels of caregiver strain. Methods: Youths were evaluated at intake (baseline) and every 6 months up to 24 months. Results: All of the caregiver completed measurement instruments showed statistical and clinical levels of improvement in youth behavioral and emotional strengths, mental health symptoms, and caregiver stress by the 6-month data collection point that was sustained through 24-month. Youths rated themselves as having fewer problems than the ratings given by caregivers at intake. Changes across the youth rated instruments did not show significant improvement until the 12 or 18-month data points. The findings of this study are overall favorable for using a wraparound service delivery model in systems of care for youth experiencing a SED.