Children who have been abused and neglected may have a variety of medical problems not apparent to a social worker or other nonmedical professional investigating the allegations. A joint project between a state child protective agency and an urban teaching hospital was undertaken to provide for the systematic medical screening of all children brought to the agency before their placement in foster care. These children received a complete medical evaluation with emphasis on documenting the abuse and neglect and also were screened for other medical problems. A total of 5181 children were evaluated. Forty-four percent of these children had some medical problem, including anemia, otitis media, sexually transmitted infections, and lead poisoning. Additional instances of abuse and neglect were identified and documented. This systematic evaluation allows for the optimal identification, documentation, and treatment of abuse, neglect, and other medical problems that may affect a child's outcome and adaptation.