Objective: To examine the effects of duration of institutionalization and age of abandonment on mental and physical health outcomes of young institutionalized children in Romania. Method: Currently institutionalized children in a Romanian orphanage (ages 2-7) were studied through caregiver reports. Orphanage staff completed questionnaires on children’s psychiatric symptoms. In addition, they provided physical growth measurements and placement history. Results: Overall, children showed high rates of developmental delays, anxiety/affective symptoms, and physical growth delays. Duration of institutionalization related to anxiety/affective symptoms. Physical growth was negatively associated with anxiety/affective symptoms and developmental delays, and positively associated with disruptive behavior. Findings are interpreted in light of implications for intervention and social policy.