This review on recognizing and responding to suspected maltreatment of children with medical complexity is organized around several questions: 1) What is meant by the term, "children with medical complexity?" Does this term represent something distinct from "children with special health care needs," or "children who are medically fragile?" 2) What constitutes medical neglect of children with medical complexity? How can it be distinguished from expected and reasonable shortcomings in the care that can realistically be provided to a child? 3) How can health care providers recognize instances of "medical child abuse" in which the harm results from interventions that health care providers undertake in response to exaggerated or fabricated reports from parents or other family caregivers? 4) What are some of the challenges facing mandated reporters and members of the health care and case planning teams in recognizing and responding to suspected medical neglect or abuse of children with medical complexity?