This article considers the experiences of families and professionals in case reviews where a child has died/suffered serious injury as a result or abuse or neglect. There is an expectation in the four UK nations that families will be included in such case reviews. The article draws on a study of policies and practices, and family accounts of involvement. An overview of UK policies and practices is described, and the broader questions that emerge for participatory practices identified. Family experiences in this complex area of practice are considered, and recommendations made for practice. The uneven picture of family involvement is argued to reflect uncertainty about the purpose, value and role of family involvement. Concerns are raised about the unresolved dilemmas arising from family involvement and the potential for practice to be unhelpful if not carefully examined. Copyright © 2013 John Wiley & Sons, Ltd. ‘An overview of UK policies and practices is described, and the broader questions that emerge for participatory practices identified’ Key Practitioner Messages: Family involvement in reviews is an expectation across the UK nations, but with limited practice guidance. Family perspectives add invaluable insights and support learning for future protective services. Professionals have common drivers for family involvement in reviews, but few policies articulate the purpose of participation. Family involvement raises difficult questions for participatory practices. Without further clarity and adoption of principles for practice, dilemmas will remain whatever review models are adopted.