Challenges faced by child protective workers included a lack of legislation in Guatemala establishing child neglect as a legitimate form of child abuse and a lack of alternatives to removing the child from the home. Stakeholders viewed poverty as a key theme underlying the understanding of child neglect, the perceived risk factors for neglect, and the challenges of responding to child neglect. Participants highlighted the importance of defining neglect as an intentional omission of provision of a child’s basic needs, noting that many families in Guatemala live in poverty and cannot provide for their children despite their best efforts. Other themes emerging from the data included the importance of societal and cultural norms and gender roles and relations in identifying and responding to child neglect in Guatemala. The findings have implications for policy in terms of the need to develop alternative care options for neglected children. Participants were a purposively selected group of professional and non-professional employees from governmental and nongovernmental organizations working with maltreated children. Participants completed semi-structured interviews and a series of focus group discussions focused on children’s health and well-being in Guatemala. Data analysis was conducted using the framework approach, which involves the identification and indexing of main themes. Future research should focus on developing a system for identifying children at risk of neglect in Guatemala. Tables, references