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Abstract Objective To examine mental health and community cohesion in women living in Calgary after a natural disaster considering previously collected mental health data. Methods Data from an ongoing longitudinal cohort, the All Our Families study, were used to examine mental health and community cohesion 5 months after a major flood in Calgary, Canada. Participants who had completed a baseline questionnaire before the flood were eligible for inclusion in this study (N=923). Four multivariable logistic regression models were built to examine predictors of post-traumatic stress, depression, anxiety, and community cohesion. Results Elevated anxiety before the flood was associated with 2.49 (95% CI: 1.17, 5.26) increased odds of experiencing high levels of post-traumatic stress, regardless of whether respondents lived in a flood-risk community or not. Women who experienced damage to property, or who provided help to others, were more likely to perceive an increased sense of community cohesion (adjusted ods ratio (AOR): 1.67; 95% CI: 1.09, 2.54 and AOR: 1.68; 95% CI: 1.13, 2.52, respectively). Conclusions Women with underlying mental health conditions may be more vulnerable to the psychological impacts of a natural disaster regardless of their level of exposure. Natural disasters may bring communities together, especially those who were more tangibly impacted. ( Disaster Med Public Health Preparedness . 2018;12:470–477)