This study details ethnic disparities that exist between American Indian/Alaska Native (AI/AN) youth and White, African American, and Hispanic/Latino youth based on secondary data analysis of Youth Risk Behavior Surveillance Survey from surveys conducted in 2003, 2005, and 2007. Items were selected for secondary analysis based on their relevance to one of five categories including (a) Violence or delinquent behaviors, (b) substance use, (c) sexual behaviors, (d) experience of victimization, and (f) suicide-related behaviors. The analyses suggest that pervasive levels of disproportionality exist between AI/AN youth and youth of other race/ethnicities on an array of risk items. These differences are most profound between the AI/AN and White youth populations, but also exist in numerous areas between the AI/AN and both African American and Hispanic/Latino youth. The findings highlight elevated levels of victimization, drug use, and suicidal behaviors among AI/AN youth. These data must be filtered through the realities of growing up in Indian Country, and must include positive factors not identified in the Youth Risk Behavior Surveillance Survey. Future research should focus not only on disparities, but on culturally appropriate interventions that have been successfully used to address the unique trauma experienced by youth living in AI/AN communities.