Few studies have examined strategies to address sleep difficulties and promote sleep health in pediatric primary care. The aims of the current study are to (a) describe the content, acceptability, and preliminary feasibility of the Sleep Checkup delivered by behavioral health providers in two urban primary care clinics and (b) report child sleep outcomes from the implementation of the Sleep Checkup. Participants were 83 children ages birth to 18 years, presenting to their primary care provider (PCP) for a sick- or well-child visit. Thirteen faculty PCPs responded to an anonymous survey about their perception of the service. The percentage of parents with concerns about their child’s sleep ranged from 0% for newborns to 41.6% for preschoolers. Of those reporting no concern, more than half subsequently reported sleep symptoms or practices suggesting a sleep problem or disorder. Providers reported overall high satisfaction. They rated the service as beneficial to providers (M = 4.85; 5 = strongly agree), to patients (M = 4.77), and to trainee learning (M = 4.77). Providers did not find the Sleep Checkup disruptive to patient flow (M = 1.08; 1 = strongly disagree). High rates of problematic sleep habits and symptoms of sleep disorders were found in an urban primary care sample, including in children whose parents denied any sleep concerns. (PsycINFO Database Record (c) 2018 APA, all rights reserved)