This study examined the relative contribution of objective risk factors and meaning-making to grief severity among 157 parents who had lost a child to death. Participants completed the Core Bereavement Items (CBI; Burnett, Middleton, Raphael, & Martinek, 1997), Inventory of Complicated Grief (ICG; Prigerson et al., 1995), questions assessing the process and degree of sense-making and benefit-finding, and the circumstances surrounding their losses. Results showed that the violence of the death, age of the child at death, and length of bereavement accounted for significant differences in normative grief symptoms (assessed by the CBI). Other results indicated that the cause of death was the only objective risk factor that significantly predicted the intensity of complicated grief (assessed by the ICG). Of the factors examined in this study, sense-making emerged as the most salient predictor of grief severity, with parents who reported having made little to no sense of their child's death being more likely to report greater intensity of grief. Implications for clinical work are discussed. © 2008 Wiley Periodicals, Inc. J Clin Psychol 64:1–19, 2008.