Early intervention efforts to promote healthy child development have long been a central feature of social service and public health reforms. Today, prenatal care, well-baby visits, and assessments to detect possible developmental delays are commonplace in most communities. Recently, child abuse prevention advocates have applied a developmental perspective to the structure of prevention systems, placing particular emphasis on efforts to support parents at the time a woman becomes pregnant or when she gives birth. The concept that learning begins at birth, not when a child enrolls in kindergarten, has permeated efforts to improve school readiness and academic achievement. Although a plethora of options exists for providing assistance to parents around the time their child is born, home visitation is the flagship program through which many states and local communities have reached out to new parents. The purpose of this paper is to promote analytic thinking and use of evaluative research. The sections of the report review the evolution of home visitation programs and the research evaluating this intervention, discuss improvements that have taken hold in home visitation programs, and outline reasonable expectations for home visitation programs moving forward.