Background: While there are various pathways by which children experience parental incarceration or foster care, involvement in either system is associated with adverse health outcomes. Despite co-occurring risk factors for parental incarceration and foster care, little is known about the prevalence or characteristics of youth navigating both of these experiences. Objectives: This study details the prevalence of youth at the intersection of parental incarceration and foster care, their demographic characteristics, and heterogeneity in their mental health. Participants and setting: Data come from the 2019 Minnesota Student Survey with 112,157 eighth-, ninth-, and eleventh-grade students. Methods: Logistic regression with interactions between parental incarceration and foster care predict associated odds of youth's anxiety and depression; self-injurious behavior, suicidal ideation and attempt; and mental health diagnoses and treatment. Results: Nearly 2 % of students experienced both parental incarceration and foster care, with a disproportionate number of those identifying as youth of color, experiencing poverty, and/or living in rural communities. Both parental incarceration and foster care were separately linked with poor mental health, yet experiencing both was associated with higher odds of anxiety, depression, self-injury, suicidal ideation, suicide attempt, diagnosis, and treatment. Youth with proximal multiplicative exposure (recent foster care and current parental incarceration) reported the most adverse mental health symptoms. Conclusion: The study emboldens what is known about the inequitable distribution of parental incarceration and foster care. These findings highlight the association between dual-systems-impacted youth and mental health indicators, with important implications for increasing access to mental health services while simultaneously calling for systems change.