This study used a survey approach to investigate current developmental surveillance and developmental screening practices by pediatric primary care providers in a diverse New Jersey county. A total of 217 providers were contacted with a final sample size of 57 pediatric primary care respondents from 13 different municipalities. Most providers (73.7%) began developmental surveillance at the first nonhospital health supervision visit, usually at 3-5 days of life. About half of responding providers (51.8%) did surveillance and/or screening at all health encounters, whereas the remaining providers (48.2%) did surveillance and/or screening at only well child visits. The majority of providers (63.6%) report using a formal tool for developmental screening. There was variation in the particular developmental tool used for screening that included the use of both standardized formal and nonstandardized informal tools. Disparities in practice were associated with the patient's type of insurance, age at surveillance and/or screening initiation, and the time frame of surveillance and screening. Implications for early intervention practice are discussed.