Studies of adolescent community samples suggest that substance use, risky sexual behavior, delinquency, and other problem behaviors can be explained in part by a single, underlying factor or syndrome. Of current interest is the generalizability of these findings to subgroups or special populations of youths who may be at high risk for problem behavior. Studies suggest that maltreated youths are at significantly elevated risk for involvement in multiple problem behaviors, but little is known about the structure of problem behavior in this high-risk population. This study used confirmatory factor analysis to examine the structure of problem behavior (that is, delinquency, substance use, and risky sexual behavior) in a sample of 149 youths with a history of abuse and neglect. It also extended current research by including a measure of self-destructive behavior. Findings indicated that a single-factor model provided a close fit for these data and compared favorably with three competing two-factor models. The single factor explained 54% of the variance in the four measures of problem behavior. Multigroup confirmatory factor analysis indicated that delinquency and substance use had consistently high loadings for both male and female youths, whereas the loadings for sexual and self-destructive behaviors differed by gender.