The aim of this study was to investigate a problem that is related to pre-school teachers' prolonged and temporary concerns for children's home situations and the extent to which these children were in need of special support in pre-school and/or were reported to the CPA. Data were obtained from a Swedish prospective study (the SOFIA-study) including 2,017 pre-school children. In this specific study, data from pre-school teacher and parent questionnaires were analyzed (baseline 2010, follow up 2011). Four groups were compared: no concern (85%), newly arisen concern (6%), previous concern (5%), and prolonged concern (4%). When pre-school teachers expressed prolonged concerns for the children's home situations they not only expressed lasting multiple concerns for children's health and development but also reported long-term problems in the contact between staff and parents. There was an obvious association between concern for the home situation and assessed need of special support in pre-school (37% in the prolonged concern group). Reports to the child protection agency were made in a minority of the cases. In conclusion, pre-school teachers' concern for children at risk of maltreatment can be understood from a broad perspective on children's health and development. This study highlights the importance of early assessment of the child's home situation, to ensure that proper support is given.