This study examined whether content and performance in story stem narratives were associated with children’s social competence, and whether children’s symptom levels moderated these associations. Five-year-old children from a clinically enriched Swiss sample completed eight stories (N = 187). Teachers rated children’s social competence. Parents and teachers rated behavioral/emotional symptoms that were used to categorize children into clinical (n = 80), borderline (n = 31), and normal (n = 74). Controlling for gender and verbal competence, no differences were found in story responses between normal and clinical children. However, pro-social/moral and disciplinary themes, and coherence and quality of narration were significantly associated with children’s social competence. The associations between narratives and social competence were prominent in the clinical children, suggesting that narrative assessments may help to identify resources on which psychotherapeutic approaches can build.