This qualitative study explored school social workers' relationships during instances of abuse and neglect reporting, focusing on reports made for children and adolescents already receiving school social work services. Although school social workers frequently file abuse and neglect reports, little is known about how they manage clinical and professional relationships in the complex school environment when reporting. This study obtained rich descriptions of their reporting experiences. In-depth interviews and a focus group were conducted with 10 participants from Texas, Florida, and Colorado, representing all school levels. Findings describe complex clinical and professional relationship networks involved in reporting and school social workers' perspectives on case management during disclosure and reporting. Thematic analysis of interviews identified several themes pertaining, for example, to communications with caregivers and children about Child Protective Services reports, interprofessional collaboration, and management of dilemmas regarding trust and confidentiality with families and professionals. Participants sought to mitigate harm through their practices, yet practices varied. Further research on the effects of practices such as involving children in reporting is warranted. Implications for practice and education are discussed. The author recommends that discussions of legal and ethical aspects of reporting be augmented with discussion of interpersonal dynamics that come into play.