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Researchers have studied juveniles at the intersection of child maltreatment and delinquency for decades. These studies capture the prevalence, outcomes, and demographics of youth who navigate the child welfare and juvenile justice systems, otherwise known as dual system youth. What is lacking is an investigation into the complex decisions and processes occurring at the intersection of these two systems. Using semi-structured and in-depth interviews, the current study investigates how practices at the juvenile justice and child welfare nexus are re-creating racial and gender inequalities. The findings reflect how racial and gender inequalities are perpetuated through three pathways that practitioners interpret as “problematic”: (1) untreated psychosocial needs, (2) victimization and subsequent sexual behaviors, and (3) low-functioning behaviors and subsequent lack of treatment. I outline the practical and theoretical implications of the identified pathways and mechanisms. I also identify risk factors for considering dual-system youth populations, discuss differences across study sites, and reveal the service gaps evident in the child-serving institutions handling dual-system youth.