How children and families get access to services and supports is critical to the provision of timely help and protective interventions. In this article, the major findings of the front door policies, processes, and practices used across 25 jurisdictions in developed countries are described and assessed. The use and outcomes of actuarial and consensus-based tools to assess risk of harm are examined, and the systemic limitations of such are explored including the potential for misapplication of the tools. Key issues and trends are identified including the increasing use of practice frameworks used in conjunction with risk assessment tools, the development of culturally safe approaches to practice, and the use of differential response to address relational problems such as service user hostility and referrals to community-based supports. The growing use of public health approaches to prevention was identified along with reform agendas to address the difficult task of building system communication, collaboration, and integration. The need for greater use of community development approaches to mobilize informal support networks for struggling families and communities is proposed. Because there are no “off-the-shelf panaceas” available, the importance of jurisdictions ensuring that system changes are undertaken with consideration of their local context and needs is highlighted by these developments.