There is increased recognition that preterm neonates require sequential surveillance to capture the spectrum of coordination, communication, learning, and behavior regulation disorders that may occur in the first 5 years of life and beyond. In particular, the framework of follow-up needs to go beyond the detection of cerebral palsy, blindness, and deafness in the first 2 years of life for only those at highest preterm risk (ie, <28 weeks gestation, with combinations of severe cranial sonographic abnormalities, bronchopulmonary dysplasia, and retinopathy of prematurity). In addition, there are numerous barriers for diverse families in accessing quality, comprehensive early intervention and early child education supports. This article highlights recent research on the long-term impact of preterm birth with a focus on disparities in resource access and in outcomes at entry to kindergarten and early educational trajectories. Across all degrees of prematurity, children from disadvantaged backgrounds face significant disparities both in access to comprehensive and continuous supports and in long-term academic outcomes. Ten key recommendations are provided for ensuring proactive management strategies for the long-term academic, behavioral, and social success of these at-risk children. [Pediatr Ann. 2017;46(10):e360-e364.].