ABSTRACT Caregiver trust in medical providers and the healthcare system is essential to pediatric primary care. Relatively little research has been conducted on contributors to caregivers’ trust, or lack thereof, in aspects of pediatric primary care, especially for those who have experienced adversity. To examine the relationship between caregiver trust and adverse childhood experiences (ACEs) in pediatric primary care, we measured four aspects of trust in 76 caregivers (74 mothers, 2 aunts) of children at an urban primary care clinic. We ran correlation and regression analyses to examine the relationship between the Philadelphia ACEs and caregiver trust. Results indicated that specific ACEs (e.g. experiencing abuse) were associated with caregiver mistrust in the healthcare system and lower trust in the child’s pediatrician. Some ACEs (e.g. community discrimination) were associated with only general trust. Thus, the relationship between trust and trauma varied based on the levels of trust and types of ACEs.