The social environment of a child is a key determinant of the child’s current and future health. Factors in a child’s family environment, both protective and harmful, have a profound impact on a child’s long-term health, brain development, and mortality. The social history may be the best all-around tool available for promoting a child’s future health and well-being. It is a key first step in identifying social needs of a child and family so that they may benefit from intervention. This article focuses on key social history elements known to increase a child’s risk of maltreatment and provides case examples.