American Indian children are overrepresented in out-of-home placements, yet research into this phenomenon is limited. We explored all first-time placements of American Indian children in 1996 and a comparison group of non-Indian children in a Minnesota county and found significant differences between the two groups. In this study, American Indian families are for the most part single-parent households and the vast majority live in poverty. American Indian children are younger and more likely to be exposed to physical neglect than their non-Indian counterparts. For both populations, alcohol use is a significant problem, yet rates are statistically higher among the American Indian families. Clearly, early prevention and intervention programs must include chemical assessment and concrete services to preserve the cultural integrity of families. To this end, emphasis must be placed on adequate funding of tribal human services, as well as collaboration among tribal, county, and state human services.