Given a lack of standardised procedures for preventing child abuse, what can be done in terms of thinking and action about the prevention of physical child abuse in health visiting and community practice? This paper reflects on knowledge gained while undertaking case series research into non-accidental head injury (NAHI), qualitative research with health visitors and mothers and fathers into the feasibility of preventing NAHI, and work as a team member of the Welsh Child Protection Systematic Review Group. Prevention is an abstract term, with dimensions of an ethical nature, and requires prompt and timely action. To identify when preventive action is required, an understanding is needed of where there is risk, and what benefit or outcome may follow interventions. However, the knowledge in this field is limited, which means that it is wise to be cautious in claiming effectiveness of prevention activity. Nonetheless, if prevention is not seen to be practised, the development of skills and the means to evaluate interventions will not become embedded in the routine care of families with small children, and physical child abuse will not be prevented.