Depression is a serious disorder with severe and far-reaching consequences. Two decades of observational research have shown robust associations between maternal depression and adverse consequences on offspring (S. Campbell et al., 2004; S. Campbell, P. Matestic, C. von Stauffenberg, R. Mohan, & T. Kirchner, 2007; S. Campbell, A. Morgan-Lopez, M. Cox, & V. McLoyd, 2009; National Research Council and Institute of Medicine, 2009). Depressive symptoms may pose particular risk to infants and toddlers with neurodevelopmental disabilities, whose long-term outcomes depend heavily on the provision of early intervention (EI). EI is most effective with active parental engagement. Maternal depressive symptoms may reduce parental engagement, thereby limiting EI benefits to the child (B. N. Gaynes et al., 2005; O'Hara & Swain, 1996). At present, maternal mental health is not directly addressed in EI. The purpose of this article is to discuss the literature and significance of maternal depression and apply that evidence to mothers of children with developmental delays and disabilities. We conclude that maternal mental health and well-being are currently insufficiently addressed in the EI population. An increased integration of mental health and EI services is needed to serve the unique needs of families who face an increased risk of stress and depression, while coping with their child's special needs.