This paper reports a study carried out in four primary care NHS trusts (PCTs) in the Midlands in order to inform inter-agency training and service planning around autism spectrum disorder (ASD). The aim of the study was to identify generic health visitors' perceptions of their role with families where children may have an ASD. The qualitative methodology is explained and key findings presented. Eleven health visitors participated as volunteers in one-to-one semi-structured interviews that were tape-recorded. Analysis of the data found some perceived tensions between health visitors' public health role and their work with individual families, especially when children had possible disabilities. Health visitors identified a role in the early identification of children developing atypically and in family support. Health visitors' perceptions are described and implications discussed. Recommendations are made regarding developmental assessment, training and service planning.