Many families live on the financial edge, but a natural disaster can throw even better-situated families into financial turmoil. Comparing the financial outcomes of residents in areas hit by natural disasters with otherwise similar people in unaffected communities, this study finds that natural disasters lead to broad, and often substantial, negative impacts on financial health and that the effects persist or even worsen over time. We also find that medium-sized disasters, which are less likely to receive long-term public recovery funding, appear to lead to larger negative effects on financial health—from declining credit scores to increased debt in collections—than large disasters. And communities more likely to be struggling financially before disasters strike are often the hardest hit by the disaster. Our findings provide insight into strategies to promote resilience and recovery and are discussed in the brief.