Studies have documented increased psychoactive medication use rates among children, but little is known about what child and/or family characteristics predict medication treatment in community-based care. This study examines the role of parent characteristics in children's medication treatment, while accounting for other potential predictors. Participants included 213 children ages 4-13 with disruptive behavior problems. Medication treatment was assessed by parent report; potential predictors of medication treatment, including child characteristics and parent characteristics (e.g., education level, perceived strain and psychopathology) were assessed at service intake. Over 60 % of children used a psychoactive medication during the 16 month study period (most commonly stimulants). Parent education level and reported strain were significant predictors of children's medication treatment even when accounting for other significant predictors such as child diagnosis, age, race/ethnicity, etc. Results highlight the role that parent characteristics have in accessing community-based medication treatment for children with disruptive behavior problems.