Background: Educational and healthcare systems operate in silos. Few studies explore educators' perspectives of collaboration with pediatricians or cross-system solutions for school-identified concerns. We sought to investigate educators' viewpoints of collaboration with pediatricians. Methods: We conducted semistructured, qualitative interviews with full-time teachers, vice-principals, and principals, who worked with low-income first- or second-grade students. Interviews explored which students were concerning to educators, educators' experiences with collaboration, and barriers and facilitators of collaboration. Interview transcripts were analyzed with modified grounded theory. Results: We interviewed 12 teachers and 3 principals/vice-principals. Students' socioemotional problems were a foremost concern. Effective collaboration with pediatricians was not typical. Participants described not knowing they could communicate with pediatricians or that collaboration was often limited or unidirectional. Respecting boundaries of parental privacy and maintaining parental trust emerged as potential barriers. Some participants described negative experiences with pediatricians and reflected on societal perceptions of doctors and teachers, which could affect the development of relationships. Participants recognized potential benefits to collaboration, including gaining a holistic understanding of a child's health and home life. Conclusions: Educators perceived collaboration with pediatricians as inadequate. More developed and tested programs that foster collaboration between schools and pediatricians are needed to support low-income youth.