Despite growing research and clinical interest in avoidant restrictive food intake disorder (ARFID), robust, evidence-based guidance on optimal treatment interventions, appropriate clinic structures, and modes of service delivery remain absent. Current consensus recommendations include a multi-disciplinary, multi-modal approach to assessment and treatment, with out-patient care being appropriate for the majority of patients, yet to date there is no clear guidance on how this might best be organised or implemented. This lack of guidance is due to a number of factors, that include the time required to conduct the necessary controlled trials and other well-designed investigations and for the subsequent body of research evidence to build. Lack of specific treatment guidance may also be related to the heterogeneous nature of ARFID clinical presentations potentially limiting the likelihood of uniform recommendations. This situation presents a challenge for clinicians required to engage in evidence-based practice, and for health care planners, providers, and policy makers. We describe here a proposed evidence-informed framework for care, subjected to preliminary testing and currently in use in an out-patient eating disorders service for children and young people aged 2–17 years. The use of the simplified care pathway diagram is illustrated with three case examples, and intended to serve as a possible model for further testing in a range of settings. In the face of ongoing uncertainty and inconsistency in the clinical management of ARFID, our intention is to share our experience in the form of an evidence-informed, trialled approach to structuring and providing intervention for this patient population.