We investigated the profiles of children and youth in street situations in Mlango Kubwa slum in Nairobi. Through a quanti-qualitative questionnaire, we collected the responses of 300 children and youth, starting from the social determinants of health as indicators of vulnerability. The foremost objective is to understand their social and health conditions as vulnerable/at-risk street groups. The secondary goal is to identify the populations’ strengths, inspecting protection mechanisms, survival strategies and dreams. The data show a complex situation: experiences of trauma, violence, conflict and abandonment; ambivalent family ties, school drop-out, lack of legal and physical protection, homelessness, living below the limit of extreme poverty. The street has activated survival strategies, mostly on an individual level, but functioning as a “base system” the street seems to act as a protective system and a possible scenario in which to create a different future together with youth workers: reconnecting with the family, liaising with expert figures in order to return to school or look for suitable training. Working with children and youth in street situations highlights the complexity of their vulnerability. This could be addressed through an integrated approach and a comprehensive primary health care model.