Lesbian, gay, bisexual, transgender, queer/questioning, and two-spirit (LGBTQ2S) youth are often over-represented in foster care systems, and frequently face discrimination both inside and outside of the child welfare system. Recently there has been growing acknowledgement that providing safe, stable, and accepting foster care placements for these youth is a crucial area of work that needs improvement. However, there is very little evidence about how to go about doing that. As part of a study testing the efficacy of a relationship building-focused foster parent training program, we conducted three focus groups with LGBTQ2S youth in care, foster caregivers, and child welfare staff to explore (a) what are the unique challenges or support needs for LGBTQ2S youth in foster care and the foster families caring for them, and (b) what strategies are recommended to build better relationships between LGBTQ2S youth and their foster caregivers? Focus group transcript data were analyzed using conventional thematic content analysis (Hsieh & Shannon, 2005). Themes addressing unique challenges and support needs included individual-level challenges, family-level challenges, and societal/ institutional challenges. A variety of themes addressing relationship building strategies emerged, including those related to caregiver/youth interactions, creating a safe and accepting space, building relationships through shared activities, and caregivers interacting with society on youths’ behalf, among others.  These findings can be used by foster care providers and researchers to improve the effectiveness of programming for LGBTQ2S youth in care and their caregivers, and in particular interventions aimed at improving placement stability and permanency for these youth.