African American families of youth with Attention-deficit/hyperactivity disorder (ADHD) traditionally have lower rates of ADHD treatment compared to nonminority groups. These treatment disparities underscore the importance of better understanding the barriers to treatment for these families. Therefore, in a sample of 67 African American caregivers of children with ADHD, the current study examined (1) factors that predict barriers to treatment for African American families of children with ADHD and (2) whether caregiver impairment mediates comorbid behavior problems and barriers to treatment for African American youth with ADHD. Analyses revealed that caregiver impairment predicted barriers to treatment and mediated the relationship between comorbid behavior problems and barriers to treatment. These findings highlight how caregiver impairment may play a significant role in preventing African American families from engaging in ADHD treatment for their child. Furthermore, targeting caregiver impairment in treatment may be particularly beneficial for African American families of youth with ADHD.