This study examined the prevalence and correlates of psychopathology in gifted children (GC) and explored whether giftedness confers protection or risk for mental health problems. We used a comparative design to analyze a population-based sample of 100 GC and 100 controls matched by age and sex in Turkey. We assessed psychiatric diagnoses with the Development and Well-Being Assessment (DAWBA), a valid diagnostic tool for child and adolescent mental health, and measured resilience and temperament with standardized scales. GC and controls did not differ significantly in the frequency of psychiatric disorders. However, GC showed lower resilience and higher negative reactivity and activity than controls. Negative reactivity was a significant predictor of psychopathology in GC. Sex did not moderate the effects of giftedness on mental health outcomes, resilience, or temperament. Our findings suggest that GC may have increased vulnerability to stress and reduced coping skills. We highlight the need to identify and support GCs who experience mental health problems and face psychological challenges. Our results emphasize the importance of early intervention and prevention to enhance resilience and well-being in this population. Future research should investigate the underlying mechanisms and develop tailored strategies to support the mental health and well-being of GC.