Most Rainbow young people with a disability or chronic condition reported positive family and school environments. However, members of this group also reported very high rates of mental distress. Only 27% reported good wellbeing, over 70% reported clinically significant symptoms of depression and over 60% reported serious thoughts of suicide in the last year. These are alarming statistics and are much higher than comparison groups. Rainbow young people with disabilities or chronic conditions reported higher forgone healthcare than all other groups and reported feeling less safe at school than those without disabilities or chronic conditions. They reported significantly higher food and housing insecurity and poorer healthcare access than non-Rainbow young people without disabilities or chronic conditions. We can improve wellbeing for Rainbow young people with disabilities or chronic conditons by ensuring that they are free from discrimination and have access to the resources they need, and that all environments are inclusive, welcoming and safe. We must ensure that the urgent mental health and wellbeing needs of Rainbow young people with disabilities or chronic conditions are met.