According to the Swedish Social Services Act, all health personnel are required to report children whom they suspect are subject to maltreatment. This paper describes the organizational and professional conditions in four Swedish children's hospitals regarding the reporting process. Specifically, the study focused on knowledge of risk to children, legal frameworks and the perceptions of organizational support and explored the differences between the hospitals and professional groups. The method used was a quantitative questionnaire, and 295 personnel responded. Hospitals differed in the level of organizational support offered to staff. Importantly, the professional groups showed different levels of knowledge and awareness about structures supporting their reporting obligations, with nurses and nurse assistants showing a lower level of awareness than physicians and hospital social workers. The paper argues that all professional groups need to have equal access to education, with the opportunity to become more involved in the assessment and reporting process and to strengthen multidisciplinary structures. Further, this would reduce risk, dispel the perception that work with children is ‘dirty work’ and counter strategies of avoidance among some professionals.