Evidence shows that children and young people with disability experience violence, abuse, and neglect at rates considerably higher than their peers. Despite persistent efforts to address it, these rates do not appear to be declining over time. As Australia moves towards implementing a national policy of personalised disability support, new opportunities and risks arise concerning personal safety in young people's lives. This paper reviews the existing evidence on abuse and neglect of children and young people with disability to help identify the nature of these risks and potential ways of thinking about and responding to these. Applying a social ecological lens, the discussion points to the importance of working productively with the multidimensional realities of these children's lives at a time when the policy and services designed to support them are also in a state of flux. The paper invites and challenges researchers, policymakers, and practitioners to engage critically with the knowledge already available and to question more deeply why abuse and neglect continue to diminish the lives of children and young people with disability.