Purpose: Risk factors for children’s development are multifarious and co-occur, having cumulative as well as individual impacts. Yet common configurations of early childhood risks remain little understood. The current study aimed to identify patterns of early risk exposure and to examine their relationship with diverse outcomes in middle childhood. Methods: Using latent class analysis in a large, community- based, UK sample (N = 13,699), we examined 13 putative risk factors to identify patterns of exposure. Results: Four risk configurations were identified: low (65 %), socio-demographic (14 %), family dysfunction (12 %), and multiple (9 %) risk classes. As expected, children in the low risk group fared best on all outcome measures, and those with multiple risk, worst. Importantly, specificity in associations with outcomes emerged, such that cognitive outcomes were predominantly linked with socio-demographic adversities, emotional difficulties with family dysfunction, and conduct problems increased across risk classes. Conclusions: Better understanding of configurations of childhood risk exposures may help to target resources for children in need.