ICJIA researchers conducted an evaluation of the Safe From the Start (SFS) program to identify the characteristics, risk factors, and the impact of violence and service provision on children and their caregivers. Administrative and assessment data collected from July 1, 2001, to June 30, 2020, representing 4,823 children who had received services across nine SFS sites in Illinois were analyzed. Findings indicated that most children referred for services had witnessed domestic violence (81%) and that 39% of children were at risk for social-emotional delays and 41% had presented with emotional and behavioral problems. Additionally, 43% of caregivers had elevated parental stress at intake. Analyses of matched pre-and post-intervention data indicated a significant reduction in children’s problematic emotional and behavioral symptoms and in caregiver’s parental stress after service receipt. Challenges and strategies to enhance the effectiveness of service provisions for young children exposed to violence are discussed.