Adverse childhood experiences (ACEs) are stressful or traumatic events that place children at risk of negative health, mental health, and behavioral outcomes. The Center for Youth Wellness (CYW), working in partnership with the Bayview Child Health Center (BCHC), pioneered ACE screening for children and adolescents. This article describes the theoretical framework and rationale for ACE screening in a primary care pediatric setting, introduces the CYW Adverse Childhood Experiences Questionnaire (CYW ACE-Q), and describes the BCHC-CYW Integrated Pediatric Care Model aimed at addressing the effects of ACEs and toxic stress. Considerations for the implementation of ACE screening are also reviewed.