The long term poor health outcomes in people who have experienced multiple adverse events in childhood have been well documented since the original CDC-Kaiser study in the late 1990's. Those people who have experienced four or more adverse childhood experiences (ACE) are at significantly increased risk of chronic disease such as cancer, heart disease and diabetes as well as mental illness and health risk behaviours. The ACE pyramid is a model that describes the relationship between ACEs, disease and potentially early death. There is growing evidence of the ways in which adversity and toxic stress, cause these poor outcomes. Exposure to adversity has been shown to alter the molecular and genetic makeup of a child as well as changing the way the neurological, immune and endocrine systems develop and function. Adverse events in childhood are of great public health concern given the evidence of their long term impact on health. This article describes the significant impact of ACEs on the health of future generations outlining the research background to ACEs. It also explores how we are finding ways to mitigate their adverse effects by prevention and promotion of resilience against the effects of adversity.