This policy essay from the Journal of Family Strengths explores the overrepresentation of LGBTQ youth in the US child welfare system and how to foster greater acceptance, inclusion, and trauma-informed care for these children. The essay describes some of the pathways that lead LGBTQ youth to be placed in foster care and the experiences of LGBTQ youth in care, including an increased vulnerability to traumatic stress, as well as suicide and self-harm. The essay also includes practice considerations for enhancing trauma-informed child welfare practices with LGBTQ youth, such as family acceptance and preservation, placement stability and foster family acceptance, enhancing social support, and creating safety for LGBTQ youth in care. The essay concludes with implications for child welfare practice and reserach.