The empirical base on early child abuse prevention is rapidly expanding. Controlled studies paint a promising yet complex picture of various intervention designs. Several emerging trends in the studies point to the essential role of parent education, the importance of linking families with formal and/or informal supports, the importance of coupling longer-term interventions and those employing paraprofessional helpers with a moderate to high degree of service intensity, a clinical advantage for programs based on universalistic intake procedures over programs that screen for psychosocial risk, and the importance of health education to reduce medically related maltreatment risk. Significant directions for future child abuse prevention program design and study are identified, particularly with respect to the role of parental powerlessness in the makeup of physical abuse and neglect risk. Eighteen early child abuse and neglect prevention studies, designs, and outcomes are summarized in tabular form. 112 references and 1 table