Child maltreatment is a leading cause of health inequality, with the socioeconomically disadvantaged more at risk. It worsens inequity and perpetuates social injustice because of its far-reaching health and development consequences. In spite of child maltreatment being a priority in most countries in the WHO European Region, few have devoted adequate resources and attention to its prevention. This report outlines the high burden of child maltreatment, its causes and consequences and the cost−effectiveness of prevention programmes. It makes compelling arguments for increased investment in prevention and for mainstreaming prevention objectives into other areas of health and social policy, reflecting the whole-of-society approach promoted by Health 2020 and the need for increased intersectoral working and coordination. The report offers policy-makers a preventive approach based on strong evidence and shared experience to support them in responding to increased demands from the public to tackle child maltreatment. Prevention programmes that stop maltreatment from occurring in the first place and reduce children’s exposure to adversity have wide-ranging public health and societal benefits.