Findings on posttraumatic growth (PTG) and distress have not been consistent. This study examines the relationship in a very long-term perspective. The Posttraumatic Growth Inventory was completed by 46 survivors from a single disaster 27 years posttrauma. Posttraumatic stress was measured by the Impact of Event Scale (IES) immediately after the event, and after 1, 5, and 27 years. In the final follow-up, general mental health was also assessed. Strong positive associations were found between PTG and concurrent posttraumatic stress. Although weaker associations were found for the past, concurrent problems in general mental health clearly coexisted with PTG decades after a disaster, yet mediated by IES.