<p>According to the popular counterfactual account of harm and benefit, something benefits (harms) someone just in case it leaves them better (worse) off than they would have been without it. As its name suggests, the counterfactual account foregrounds counterfactual dependence as the guide to the nature of harm and benefit. In spite of this account’s many attractions, it is known to face extensional difficulties in cases of preemption and overdetermination. In this paper, I argue that the true significance of cases of preemption and overdetermination has been overlooked, and I raise a new challenge of preemption and overdetermination. This challenge highlights how metaphysical dependence (i.e. grounding) matters for harm and benefit. I argue that no version of the counterfactual account adequately answers the new challenge, and I defend a novel account that answers the challenge and, in doing so, illuminates the role of grounding in the theory of harm and benefit.</p>