Finding and serving twice exceptional learners is a complex task requiring commitment and support on varying levels. We must ensure that every child who has the capacity to succeed in advanced academic programs has access, accommodations, and support. Knowing how many children there are, whom we can correctly identify as twice exceptional, may help with an educator’s planning on how to meet the needs of these learners. The prevalence found along with the management of diverse cognitive, affective, and behavioral needs will be examined. The issues about identification validity, misdiagnosis vs. diagnosis, as well as the most viable and effective accommodations will also be discussed.