Child abuse and maltreatment are among some of the most egregious and traumatic situations in which pediatric clinicians may find themselves. Significant debate occurred as the pandemic-related lockdowns emerged when reporting of abuse went down in the face of informal consensus among pediatric providers that it must surely be increasing. Factors considered for decreased reporting include lack of access to social safety nets and caring adults who are also mandated reporters because of school closures, enforced quarantines, and stay-at-home orders. Factors fueling speculation for increased abuse incidence include known literature about risk factors for abuse including economic, social, and relational stressors, which were certainly magnified at the height of the pandemic. This chapter will explore available evidence regarding child abuse and maltreatment. In addition, it will review pertinent emerging information learned about recognizing and responding to human trafficking when children with risk factors, discovery, or disclosure present in clinical environments.