Home-based child care accounts for a significant share of the child care supply in the United States, especially for infants and toddlers. A synthesis of the home-based care research literature and information about recent home-based care quality initiatives points to a critical need for more systematic efforts to develop and test quality initiatives for this type of child care. This article summarizes key findings on the prevalence and quality of home-based child care, caregiver characteristics, and quality initiatives and then makes recommendations for future directions.