Empirical evidence suggests maternal behavioral health problems are significant predictors of child behavioral health difficulties, but it is unclear of the specific relation of maternal alcohol use problems and depression symptoms with child internalizing and externalizing behavior problems. The purpose of the study is to examine the impact of maternal depression symptoms and alcohol use problems on children’s internalizing and externalizing behavior problems over a period of 5 years. Implications for intervention may differ depending on which type of maternal behavioral health concerns predicts which child behavior problem. A total of 1874 families eligible for Early Head Start participated. Maternal depression symptoms and alcohol use problems were assessed when children were in preschool, and internalizing and externalizing behavior problems were assessed when children were in fifth grade. Clinical internalizing behavior problems was best predicted by maternal depression symptoms, whereas clinical externalizing behavior problems was best predicted by maternal alcohol use problems. Children were almost twice as likely to have clinical internalizing behavior problems when mothers exhibited very elevated depression symptoms compared to when mothers displayed minimal symptoms. A similar relation was found with maternal alcohol use problems and clinical externalizing behavior problems. Our findings highlight the importance of understanding and treating various kinds of behavioral health concerns in mothers of young children.