Students who meet criteria for both being intellectually gifted and having a disability are known by the term ‘twice exceptional’. To date there is little known about the classroom interactions of these students, and how these interactions impact their developing self-esteem. The interactions of four gifted primary school students with identified learning difficulties (twice exceptional) were observed along with four matched typically developing students and their teacher during normal classroom teaching activities. The number and type of positive, negative, neutral or no response interactions were recorded over four, one hour observation sessions. The Coopersmith Self-Esteem Inventory was then administered to the four twice exceptional and four comparison students. Results indicated that there was little difference between the twice exceptional and comparison students in terms of number of interactions recorded, with the twice exceptional students showing slightly more positive interactions with their teacher and peers. All four twice exceptional students reported lower self-esteem levels than their matched peers, with two students being in the low range. The results suggested that these four twice exceptional students were interacting in a manner similar to their typically developing peers, although they displayed lower self-esteem levels. The implications of these findings and recommendations for future research are discussed.