In spite of widespread concern that children living with substance-misusing caregivers are experiencing greater risk for maltreatment, little research examines the direct effects of caregiver substance use on child outcomes. This systematic review investigates the work done within and across disciplines of adult substance abuse, child welfare, and child mental health, including the measurement of key terms, conceptualization of primary variables, and suggested implications for translational science to practice. The findings of the review show considerable shortcomings for examining this complex problem. To move research forward, we suggest ways to improve measures and methods to provide more robust support for inferences about child maltreatment and mental health outcomes. Abstract published by arrangement with Taylor and Francis.