We describe the gap between parents’ special education needs and pediatric primary care providers’ (PCPs) ability to address those needs from a mixed-methods study at a safety-net hospital. We conducted qualitative interviews with English- and Spanish-speaking parents (n = 25) and PCPs (n = 11) about special education knowledge and experience and interactions with a primary care–embedded special education clinic. PCPs also answered survey questions on these topics. Parents reported four challenges: (1) knowing where to start and how to advocate for their youth, (2) being heard or having a say, (3) using the “right” language, and (4) gathering information on special education resources. Primary care providers disclosed three barriers: (1) training, (2) knowledge to assess the appropriateness of supports, and (3) time to address concerns. The gap between PCPs and parents was bridged by the special education clinic. Systematic interventions can ensure that PCPs help parents address the special education needs of their patients.