We conducted a retrospective cohort study of the risk of posttraumatic stress disorder (PTSD), affective disorders, alcohol/substance-related disorders, traumatic brain injury (TBI) and insomnia, among explosive ordnance disposal (EOD) technicians in the U.S. military compared to the general U.S. military population. Administrative and healthcare utilization data from fiscal year 2004 (FY2004) to FY2015 was used for this comparison. We used propensity score matching to balance baseline covariates, and discrete-time hazard models to compare the odds of occurrence of other outcomes. EOD personnel had higher odds of having a new diagnosis of insomnia (OR=1.33; 95% CI:1.22-1.45) and PTSD (OR=1.23; 95% CI:1.08-1.41) than did non-EOD personnel. EOD technicians had lower odds of having a new diagnosis of affective disorders (OR=0.83; 95% CI:0.79-0.87) and alcohol/substance-related disorders (OR=0.59; 95% CI:0.54-0.64) than did non-EOD personnel. There was little evidence of a difference in the odds of a TBI diagnosis (OR=1.07; 95% CI:0.99-1.16). As reliance on EOD forces continues, ongoing vigilance of the stressors, health sequelae and disincentives to access mental health care among this military occupation should be monitored and mitigated wherever possible.