Adverse childhood experiences are potentially traumatic events that occur in childhood that have been associated with lifelong chronic health problems, mental illness, substance misuse, and decreased life opportunities. Therefore, preventing adverse childhood experiences is critical to improving health and socioeconomic outcomes throughout the lifespan. The Preventing Adverse Childhood Experiences: Data to Action (CDC-RFA-CE20-2006) funding initiative is a comprehensive public health approach to adverse childhood experience prevention that aims to understand the prevalence of and risk factors for adverse childhood experiences among youth, track changes in adverse childhood experience prevalence over time, focus prevention strategies, and ultimately measure the success of those evidence-based prevention strategies. Recipients will achieve the goals of the initiative by leveraging multisector partnerships and resources to: (1) enhance and build infrastructure for state-level data collection, analysis, and application of adverse childhood experiences related surveillance data; (2) implement at least 2 prevention strategies based on the best available evidence to prevent adverse childhood experiences; and (3) undertake data to action activities to leverage statewide surveillance data to inform and tailor adverse childhood experience prevention activities. Since the start of this initiative, recipients have focused on building surveillance capacity based on the needs of their individual states; implementing strategies and approaches based on the best available evidence to better prevent adverse childhood experiences; and ultimately improve the mental, physical, and social well-being of their populations. Although evaluation of Preventing Adverse Childhood Experiences: Data to Action is ongoing, this article outlines the current recipient surveillance, prevention, and data-to-action implementation efforts.