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In custodial grandfamilies, grandchildren often provide critical support and assistance to their grandparents. Less is known about the extent to which grandchildren may serve as caregivers to their custodial grandparents and how providing care may impact their well-being. Informed by the stress process model, the purpose of this study was to examine the nature of adolescent grandchildren's caregiving to their custodial grandmothers and the relationship of providing this care to grandchildren's perceived caregiving interference and internalizing and externalizing behavior problems. A survey was administered to 81 adolescents, aged 12 to 18, and their custodial grandmothers. Results suggest that grandchildren provide assistance with both instrumental activities of daily living (IADLs; e.g., housework, cooking) and activities of daily living (ADLs; walking, dressing). Results of a path analysis revealed that grandchildren's assistance with ADLs was associated with greater perceptions of caregiving interference in social and academic arenas, which was associated with increased externalizing behavior problems. Implications for practice, which underscore the necessity of interventions to support grandchild caregivers, and directions for future research, are addressed. Highlights: Grandchildren assisting grandmothers with instrumental activities of daily living, including household chores, was common. Grandchildren assist custodial grandmothers with activities of daily living (e.g., transferring, using stairs, and walking). When grandchildren assist with more activities of daily living, they report greater perceptions of caregiving interference. Grandchildren with greater perceived caregiving interference experienced more externalizing behavior problems. [ABSTRACT FROM AUTHOR]