This qualitative case study aimed to analyze the challenges faced by the Family Health Program (FHP) teams in dealing with domestic violence against children and adolescents in Teresópolis, Rio de Janeiro State, Brazil. The sample consisted of 25 professionals from three family health teams. Data were collected through face-to-face semi-structured thematic interviews and submitted to content analysis. Findings included the health professionals' detection of cases of domestic violence among families enrolled in the program, often associated with drug use and drug dealing, alcoholism, family breakdown, and poverty. Collaboration with the community and difficulty in inter-sector actions were identified as challenges for detecting, reporting, and monitoring cases. Most professionals felt insecure in dealing with such cases, due to lack of appropriate knowledge and skills. The study concludes that it is essential to managers, staff and community discuss the problem and means to approach it in the context of the territories.