This study examined the role of structural and content characteristics of children’s conflict-based narratives (coherence, positive and aggressive themes) in the association between early childhood family risk and children’s internalizing and externalizing problems in a sample of 193 children (97 girls, 96 boys) aged 3 to 5 years (M = 3.85, SD = .48). Parents participated in an interview on family related risk factors; teachers and parents completed the Strengths and Difficulties Questionnaire; children completed conflict-based narratives based on the MacArthur Story Stem Battery (MSSB). We specifically investigated the mediating and moderating role of narrative coherence and content themes in the association between family risk and children’s internalizing and externalizing problems. Children’s narrative coherence was associated with better adjustment, and had a buffering effect on the negative relation between family risk on children’s internalizing problems. Positive themes were negatively associated with externalizing problems. Telling narratives with many positive and negative themes buffered the negative association of family risk and teacher-reported externalizing problems. In sum, the findings suggest that in children, being able to tell coherent and enriched narratives may buffer the impact of family risk on their symptoms, and being able to produce positive themes rather than aggressive themes is associated with lower externalizing problems.