Home‐visitation programs for families with young children are growing in popularity in the United States. These programs typically seek to prevent child abuse and neglect and/or promote optimal development for infants, toddlers, and/or preschool‐age children. This article focuses on improving the capacity of home‐visitation programs to meet the complex needs of highly vulnerable families with young children. Poverty, maternal depression and substance abuse, and domestic violence are noted as factors that place young children at risk for poor outcomes. The challenges of providing home‐visitation services to families in which these risk factors are present are discussed. Family engagement, matching services to families’ needs, and staff capabilities are highlighted as areas in which improvements can be made to enhance home‐visitation programs’ capacity to serve highly vulnerable families. Recommendations are given for improving the effectiveness of home‐visitation programs in serving these families as well as for addressing policy and research issues related to the further development and evaluation of these programs.