In searching for a "disruptive" new paradigm to prevent child abuse, we are drawn to an older approach with unfulfilled promise. In 1993, the United States Advisory Board on Child Abuse and Neglect published their report Neighbors Helping Neighbors: A New National Strategy for the Protection of Children. The top priority recommendation of the Board was to develop programs that facilitated the development and safety of neighborhoods by establishing Prevention Zones to improve social and physical environments with high rates of child maltreatment. This paper explores how Prevention Zones might be re-imagined today, integrated with services like home-visiting and medical homes, and applied to serious child maltreatment such as abusive head trauma.