Recent findings suggest that perfectionism is highly prevalent among children and adolescents, and perfectionism can be quite destructive in terms of its links with anxiety, depression, and suicide. In this article, we provide an overview of recent research illustrating the costs and consequences of perfectionism among children and adolescents. We also highlight the heterogeneity that exists among perfectionists and the need for a complex, nuanced approach to assessment and prevention that reflects the achievement and interpersonal concerns of perfectionists. We then summarize past research on the prevention of perfectionism and show that perfectionism is pernicious and resistant to change. Accordingly, interventions must be tailored to address the cognitive and emotion regulation vulnerabilities of perfectionists and their meta-cognitive beliefs about ability, the self, and the meaning of failure. We conclude by discussing why it is essential to proactively design and implement preventive programs with specific components designed to enhance resilience and reduce levels of risk among perfectionists. We outline several themes that should be incorporated in preventive and intervention efforts designed to address the needs of vulnerable perfectionists.