Child trafficking and commercial sexual exploitation (CSE) are severe human rights violations that inflict lasting psychological and social harm on vulnerable children in the United States. This paper examines the psychological and social impacts of child trafficking and CSE in the United States, applying Bronfenbrenner’s ecological systems theory to identify risk factors across individual, familial, community, and societal levels. It explores how systemic failures, legal, social, and institutional, compound trauma and hinder recovery. The findings of this paper reveal that child trafficking and commercial sexual exploitation in the United States are driven by interconnected factors across individual, relational, institutional, and societal levels. Using Bronfenbrenner’s ecological systems theory, the study found that children with prior histories of abuse, neglect, or involvement in foster care and juvenile justice systems are disproportionately vulnerable to trafficking. Institutional failures, such as poor coordination between schools, child protection agencies, and law enforcement, often result in missed opportunities for early intervention. At the societal level, systemic racism, gender inequality, and economic hardship contribute to the marginalization of victims, particularly youth of color and LGBTQ+ children, who are often criminalized instead of being recognized as survivors. The paper also revealed that long-term effects include severe trauma, disrupted development, and social exclusion, which reinforces the need for comprehensive, trauma-informed, and culturally responsive interventions. In conclusion, addressing child trafficking and sexual exploitation requires a multifaceted, systemic approach that prioritizes prevention, early intervention, and support for vulnerable youth, while also challenging societal and institutional barriers.