The type of care setting a child is placed in when they enter the child welfare system has long-lasting effects. Although numerous studies have examined factors associated with placement decisions and placement moves, few studies have paid attention to factors involved in both placing children into and removing children from kinship care. This study focused on kinship care as the top of the hierarchy of out-of-home and utilized data obtained from a U.S. mid-Atlantic State Automated Child Welfare Information System. The study followed children who placed in out-of-home care over a three-year period. Descriptive, bivariate, and regression model analyses were conducted to identify: (1) Among children experiencing a first out-of-home care placement (N = 3838), what factors are associated with initial placement into kinship care versus non-kin foster care and group homes/residential treatment centers (RTC); and (2) among children experiencing a second out-of-home placement during this period (n = 1893; 51% of the original sample), what factors are associated with being moved from a kinship care to a less-preferred care setting and vice versa. Two factors increased the odds of initially being placed in kinship care: race of the child (African American children are more likely to be placed in kinship care) and presence of parental substance abuse; in contrast, the presence of child behavioral problems and disabilities, as well as more advanced age, decreased the odds of kinship placement. For children experiencing a second move from kinship care into non-kin foster care, the associated factors were: Older children, behavioral problems, and parental incarceration. Finally, for children placed initially in non-kin foster care and moved to kinship care, moves were primarily associated with parental characteristics, including housing issues, substance abuse, and difficulties coping with the child. Implications for policy, research, and practice are discussed.