This article examines the value of the concept of significant harm some 20 years after its introduction in the Children Act 1989. It introduces the concept of significant harm and then discusses the profile of children and families in care proceedings, the decision-making process, the interpretation of significant harm in case law, 'panic' and its impact on patterns of referrals for case proceedings, and the issue of resources. An alternative model of the problem-solving court is outlined. It is suggested that 'significant harm' has largely stood the test of time. However, the absence of a clear operational definition is both its strength and its weakness. It allows necessary professional discretion but is vulnerable to external pressures affecting its interpretation. A more confident workforce and sufficient resources are required, but the future role of the court and compulsory care is more contentious. The problem-solving court model may offer a helpful way forward for the scrutiny of significant harm.