Although it is the presence of motor and phonic tics that defines Tourette syndrome (TS), explorations over the past two decades have uncovered a complex and multidimensional nature of this genetic-based neurological disorder. Tics customarily first become apparent during the latter half of the first decade of life, although they may occur earlier, including during infancy. However, associated comorbid conditions, rather than tics, usually determine the functional and qualitative experiences for the child with TS. These conditions often become problematic prior to tic onset. Misconceptions regarding the nature of tics and the varied associated conditions are common, placing children with TS at significant risk for underdiagnosis, mismanagement, and missed opportunities for prevention. This article will consider risk factors and associated behaviors, both subtle and more obvious, that can alert the clinician to infants and young children with tics or who are at increased risk to develop TS. Themes in management strategies include interdisciplinary participation, Medical Home foundation, and ongoing monitoring and support.