Nationally representative child welfare data from October 1999 was utilized to compare American Indian/Alaskan Native (AI/AN) children to non-Indian children placed into out-of-home care. In comparison to non-Indian children, AI/AN children came from poorer homes, were more frequently placed into congregate care, and were less frequently placed into kinship care. AI/AN caregivers have greater mental health and alcohol abuse service needs compared with non-Indian caregivers. Knowledge of the Indian Child Welfare Act of 1978 (ICWA) by child protective services (CPS) workers could increase cultural competence throughout the child welfare system. A CPS system more sensitized to cultural differences may reduce disproportionate child welfare outcomes that AI/AN children experience.