This paper reviews 33 evaluations of Healthy Families America sites, with emphasis on 15 studies that include a control or comparison group. Outcome domains include child health and development, maternal life course, parenting, and child maltreatment. Parenting outcomes (e.g., parenting attitudes) show the most consistent positive impacts. Mixed results in other domains indicate the need for in-depth research to identify factors associated with better outcomes. Several factors that may contribute to differences in outcomes are discussed, including site implementation and quality, differences in family risk levels, and recent augmentations to program design. The paper also highlights two large-scale evaluations, one community-wide (Hampton, Virginia) and one statewide (Indiana), to illustrate exemplary evaluation approaches found in HFA research. Overall, HFA's continuing evolution has been positively impacted by researcher-practitioner partnerships.