Background and objective Children and adolescents with disabilities and health-related impairment belong to a vulnerable population group. There are only few German findings on mental health that distinguish between children and adolescents with and without disabilities and health-related impairment. Materials and methods Data were used from the German KiGGS Wave 2 of the Robert Koch-Institute from 2014-2017. A total of 11,830 children and adolescents aged 3-17 years were included using the parent perspective and 5,222 children and adolescents between 11-17 years using their self-assessments. Mental health outcomes were mental health problems (SDQ, parental assessment) and health-related quality of life (kidscreen, self-assessment). Univariate and bivariate analyses were conducted using cross-tables with Chi square tests and multivariate analyses using binary logistic regression models. Results In 16.5% of children aged 3-17 years, parents reported mental health problems; 48.4% of the interviewed children and adolescents aged 11-17 years reported a low health-related quality of life. Children with disabilities and health-related impairment had a significantly higher probability of mental health problems (OR: 5.11) and a low health-related quality of life (OR: 1.50). Conclusion The findings suggest a need for action to strengthen mental health in children and adolescents with disabilities and/or health-related impairment. In this context, the educational settings of kindergarten and school are of great importance.