Objective: The purpose of this study was to examine the associations among parental knowledge and beliefs about healthy sleep, sleep practices, and insufficient sleep in a pediatric primary care clinic sample. Methods: A convenience sample of caregivers of patients between 3 months and 12 years attending a hospital-based pediatric primary care clinic in an academic center completed a brief survey on (1) child sleep habits, (2) basic sleep knowledge, and (3) beliefs and attitudes regarding sleep as a health behavior. Results: Of the 184 analyzable surveys (response rate 72%; mean age of index child 4.0 +/- 3.2 years), 42% of children did not have a consistent bedtime, 43% had a bedtime later than 9 PM, 76% had a television in the bedroom, 69% frequently fell asleep with an adult present, and 18% had daily caffeine intake. Although 76% of parents underestimated their child's sleep needs compared to recommended amounts, just 8% reported that their child was not getting adequate sleep. More than half of parents believed that inadequate sleep increases the risk of being underweight and endorsed snoring as a sign of healthy sleep. An increased level of sleep knowledge was associated with a number of positive sleep practices and inversely correlated with sleep duration. Conclusion: The results of this study document the need for increased targeted caregiver education regarding healthy sleep practices, the importance of adequate sleep, the impact of insufficient sleep on health, and recognition of potential signs of sleep problems in young children, especially in high-risk populations.