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In the United States, it is estimated that more than 5.4 million children and adolescents under age 18 provide care for adult family members who are aging or have a chronic illness, disability, or other health conditions that require assistance. However, little is known about how providing care to the family during childhood and adolescence impacts youth development. We examined whether caregiving as a youth is associated with emotional challenges, peer difficulties, course grades, and physical health risk behaviors. A large, diverse sample of middle and high school students in Florida completed the first systematic school-based survey in the U.S. to date to count caregiving youth (N = 10,880; 52% female; M[subscript age] = 14.40, 40% Latinx). Youth reported the amount of caregiving they provided to the family each week, in addition to items reflecting their emotional challenges (e.g., suicidality), peer difficulties (e.g., experiences of conflict or victimization), academic course grades, and health risk behaviors (e.g., diet, physical activity, sleep). We found that Latinx and Black youth provided higher levels of caregiving to the family compared to youth from White non-Latinx, Asian, or Other ethnicities. Caregiving was associated with more emotional challenges, more peer difficulties, and lower course grades for all groups. In addition, providing caregiving was associated with a less healthy diet among older youth and sleeping less than 8 hr per night among White non-Latinx youth. These findings highlight a need to support caregiving youth and their families via policies and institutional supports. [This paper was published in "Journal of Family Psychology."]