Child maltreatment is a serious and pervasive problem. Every year, more than a million children in the United States are abused, and between 2,000 and 5,000 die as a result of their injuries. Physicians are in a unique position to detect child abuse and neglect and are mandated by law to report such cases. These guidelines were developed to assist primary care physicians in the identification and management of the various forms of child maltreatment. A brief historical introduction and specific information about vulnerable families and children are presented. The physical and behavioral diagnostic signs of physical abuse, physical neglect, sexual abuse, and emotional maltreatment are delineated. Information about specific techniques for interviewing the abused child and family, case management objectives, reporting requirements, and trends in treatment and prevention are also provided.