Factors that affect children's school readiness potential are evident from birth. Structural equation modeling was used to test the hypotheses that certain factors related to family risk conditions, the quality of prenatal care, maternal health during pregnancy, and the health status of the child at birth mediate children's readiness for school. Data from the Early Childhood Longitudinal Study--Birth Cohort (ECLS-B) was used to test the hypotheses. 10,700 children were included in the study sample that represented diverse socioeconomic and racial/ethnic backgrounds. The hypothesized model suggested that there were both direct and indirect influences on children's school readiness performance, including academic achievement and social competence. Potential risk factors as well as strategies for ameliorating negative influences on school readiness performance are identified.