Abstract Introduction Children in foster care experience impairing sleep problems that contribute to greater attachment, emotional and behavioral problems concurrently and over time. Sleep nonetheless remains a critically neglected aspect of health among this vulnerable group. To address the unique sleep needed of this population, we developed a brief, telehealth-delivered behavioral sleep intervention for caregivers of young children currently or formerly in foster care, called Sleep and Adjustment in Foster Environments for Toddlers and Preschoolers (SAFE-T). The current study examined the initial efficacy of SAFE-T. Methods N = 25 foster or adoptive foster parents with a 2- to 5-year-old child (M = 3.9; SD = 1.7) were recruited from the state of Texas. After a baseline assessment including the Children’s Sleep Habits Questionnaire (CSHQ) and Parenting Stress Index (PSI), families were randomized to SAFE-T or an active control group. SAFE-T families (n = 14) received 3 telehealth-delivered sessions with a therapist who provided information about healthy sleep and trauma-informed suggestions for reducing child sleep problems. Control families (n = 11) were sent an informational booklet about sleep to keep. A post-treatment assessment was completed approximately one month after he initial assessment. Results Compared to the control group, the SAFE-T group evidenced greater reductions in total CSHQ sleep problem scores (η2 = .14), including Sleep Anxiety (partial eta squatted = .16), Sleep Onset Delay (η2 = .08), Bedtime Resistance (η2 = .09) and Daytime Sleepiness (η2 = .07) scores at post treatment. Based on the PSI, caregivers in the SAFE-T group reported greater reductions in Difficult Child scores (η2 = .35), Parent-Child Dysfunctional Interactions (η2 = .31) and Parenting Stress (η2 = .16) compared to the control group. Conclusion Medium to very large effects were found for reductions in caregiver-reported child sleep problems as well as parenting stress following intervention with SAFE-T. These promising results suggest that a brief, trauma-informed sleep intervention may be effective in improving child sleep health and caregiver well-being in foster families. Support (if any) This study was funded by the Grant to Enhance and Advance Research (GEAR) from the University of Houston.