Compared to natives, immigrants have been reported to display either more (migration morbidity) or fewer (immigrant paradox) adjustment problems. We examined these two perspectives using a meta-analysis from 51 studies (N = 224,197), reporting internalizing, externalizing, and academic outcomes among immigrant children and youth in Europe. Overall, migration morbidity was better supported than the immigrant paradox. Migration morbidity was supported for (a) externalizing outcomes in Northern Europe and adolescent samples; (b) academic outcomes for low SES and fewer girls across samples; (c) internalizing outcomes in Western Europe and preadolescent samples. Cultural diversity and long-term residence of immigrants are favorable factors for the paradox in externalizing outcomes, whereas immigrant family reunion was predictive for the paradox in internalizing and academic outcomes. Implications for future research and policy are discussed.