The purpose of this study was to unpack notions of class, culture, and race as they relate to multidisciplinary team (MDT) professionals and their perceptions of prevalence in child sexual abuse cases in Native and non-Native rural Alaska communities. Power and privilege within professional settings is significant for all social work professionals and influences the ways in which systemic issues of power and privilege mediate decision making. Fifteen MDT participants from two separate rural communities were interviewed. Emergent themes include perceptions on incidences and reporting of child sexual abuse, cultural dissonance, and systemic challenges. Policy and practice implications are discussed. (Contains 1 note.)