The objective of this article is to present a case study examining the use of Parent–Child Interaction Therapy (PCIT) for a 5-year-old African American girl from an economically disadvantaged background who sustained a moderate traumatic brain injury. “Victoria’s” preinjury history, family environment, and injury characteristics are detailed along with the results of her baseline, postintervention, and follow-up assessments. Following 11 sessions of PCIT over 7 months, Victoria no longer met diagnostic criteria for oppositional defiant disorder and showed clinically significant decreases in her externalizing behavior problems at the end of treatment. However, maintenance of treatment gains was not observed at the 6-month follow-up assessment. The current case study highlights some of the advantages and challenges associated with the use of PCIT to treat externalizing behavior problems in young children with traumatic brain injury, especially those from economically disadvantaged backgrounds. Further examination of behavioral interventions with larger samples is needed to meet the needs of this high-risk population.