Children in the United States are exposed to alarmingly high rates of violence and trauma. Notable are the rates of maltreatment among children and the heightened risk for both out of home placement and an array of developmental, behavioral, and psychosocial sequelae. Despite these risks, little information is available on effective interventions and services designed to address the complex needs of youth in residential treatment settings. To effectively respond to their unique developmental, behavioral, and emotional needs, trauma-informed interventions and services must be provided to support optimal outcomes. To this end, this paper delineates the prevalence of children in residential care secondary to chronic maltreatment and other trauma exposures, identifies behavioral and emotional issues through the theoretical framework of complex trauma, highlights the importance of organizational capacity to deliver trauma-informed services, and describes effective clinical interventions that are often used in residential treatment. Clinical considerations and recommendations are also provided.