This study examined associations among academic achievement problems, attention problems, and cortisol levels in 86 children (ages 5 to 12) in St. Vincent, the West Indies. Findings revealed that morning cortisol levels were more elevated at school than at home. Attention problems contributed negatively to academic scores. Children with the most attention problems showed greater school relative to home cortisol elevations than did other children. Once the variance due to attention problems was accounted for, the interaction between attention problems and cortisol elevation explained additional variance in academic scores. There was some evidence that attention problems and cortisol reactivity were associated. Furthermore, greater cortisol reactivity was correlated with the academic difficulties of children who exhibited more attention problems.