To explore the extent to which disasters may be a source of injury and disability in community populations, we examined the prevalence and short-term consequences of disaster-related illness and injury for distress, disability, and perceived needs for care. A random population survey was conducted 2-6 months after Hurricane Ike struck Galveston Bay on September 13, 2008. The sample was composed of 658 adults representative of Galveston and Chambers Counties, Texas. The prevalences of personal injury (4%) and household illness (16%) indicated that approximately 7,700 adults in the two-county area were injured, and another 31,500 adults experienced household-level illness. Risk for injury/illness increased with area damage and decreased with evacuation. In bivariate tests, injury or illness or both were related to all outcome measures. In multivariate analyses that controlled for co-occurring stressors representing trauma, loss, adversities, and community effects, injury or illness or both were associated with global stress, posttraumatic stress, dysfunction, days of disability, and perceived needs for care, but not with depression or anxiety. The associations of injury with distress and disability suggest that community programs should reach out to injured persons for early mental health and functional assessments and, where indicated, intervene in ways that reduce further disability and need for complex rehabilitative services. The results also point to the potential effectiveness of evacuation incentives with regard to the prevention of disaster-related injury and disability.