Since the initial conceptualization of the medical home in the 1960s and 70s in pediatrics, its definition and principles have evolved. The addition of clinicians in family medicine and internal medicine, policymakers, payer groups, and consumer groups to medical home study and implementation has given tremendous positive momentum to the movement to create patient- and family-centered medical homes for children, adolescents and adults. While there is a great deal of similarity between medical home concepts and models for the care of adults and children, some principles should be emphasized in child and adolescent health, and a few health concepts are unique. These have important implications for how child-relevant research and policy related to the medical home should be promoted. This paper describes perspectives on the primary care medical home from the standpoint of child and adolescent health.