Caring for the preschool population presents unique challenges for the school nurse. These challenges are multiplied when the population includes those with special needs. Challenges include multiple risks to safety related to developmental stage, increased prevalence of infectious diseases due to the development of the child’s immune system, management of chronic disease because of the student’s ability to comprehend and follow directions, and many social and emotional issues. Using evidence-based strategies, the preschool nurse can gain the confidence to care for the youngest students.