Child maltreatment and spousal abuse are complex problems without simple solutions. Pediatricians can play a critical role in the early detection of abuse, carry out an initial assessment, and make appropriate referrals. By taking a family-focused perspective, and considering the social-emotional and economic context in which all family members live, the pediatrician will be more sensitive and alert to both the stressors and strengths within each family. Child maltreatment and spousal abuse affect children directly and indirectly in a variety of domains, including social-interactional, emotional status, self-image, behavior, and learning. A better understanding of these issues will enhance the comprehensiveness of the pediatrician's efforts and provide a better outcome for children and their families.