Raising a young child with challenging behavior can have a significant impact on families' well-being and family functioning. Despite advancements in the field, there is a paucity of research focused on effective ways to address their unique experiences. This qualitative meta-synthesis aims to identify the needs of families with young children who exhibit challenging behavior to inform more robust and responsive family-centered practices. Employing a constant comparative approach, we used axial coding to examine six studies involving 49 families and a critical appraisal approach to evaluate their strengths and weaknesses, based on recommendations articulated by the Cochrane Collaboration. We determined that six major themes were most salient: (a) the family system, (b) families' self-concept, (c) families' capacity, (d) families' social and emotional needs, (e) families' experiences with professionals, and (f) families' initial concerns. Our findings indicate that studies were conducted with acceptable rigor and all studies established credibility and trustworthiness of their results. The importance of family-centered practices, parenting interventions, and addressing the mental health needs of families are discussed.