Several types of professionals support families of young children with disabilities as they navigate the early intervention and early childhood special education systems (EI/ECSE). Medical professionals are often the first to discuss service provision with families, while EI/ECSE providers are responsible for evaluating, determining eligibility, and providing services. The alignment between these two groups can directly influence child and family outcomes. We explored the experiences of medical professionals and EI/ECSE providers working in one large Northeastern U.S. city to understand how each group views their respective roles within the system and to gauge the degree to which they collaborate. Our findings revealed that both groups are committed to the families they serve but are often frustrated by conflicting recommendations for EI/ECSE service delivery. We provide suggestions to improve opportunities to communicate and collaborate to increase the effectiveness of support for children and their families.