The current study examined the diagnostic decision-making of school psychologists as a function of a student's disability and academic performance with three research questions using a randomly-selected sample of school psychologists from the state of Texas. Results from the first research question indicated that school psychologists significantly differentiated between what diagnoses were considered most correct according to the DSM-IV and what diagnoses would be in a child's best interest at school. Results from the second research question indicated that this differentiation in diagnostic decision-making was present as significantly associated with academic performance. Results from the third and final research question indicated that school psychologists differed in their diagnostic decision-making according to their perceptions about the particular disability.