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Background Family level adversities such as poverty, parental mental health issues, parental substance misuse, and domestic violence limit positive outcomes in children that may ultimately promote upward social mobility including academic success, an absence of criminal behaviour, and good mental and physical health. However, previous research has typically examined these adversities and childhood outcomes at a single point in time, limiting our understanding of how these risks accumulate and interact across childhood and adolescence to influence outcomes. This study examines how family level adversities experienced throughout childhood shape the likelihood of achieving outcomes that support positive social mobility.Methods We used data from 9,316 children in the UK Millenium Cohort Study. Group-based multi-trajectory models tracked patterns of poverty and family adversity from infancy (9 months) to early adolescence (14 years), which were used as exposures in the analysis. The outcome was ‘Positive Social Mobility Profile’ (PSM), a binary variable constructed based on successful completion of age 16 exams, low risk of self-assessed ill health, low risk of obesity, low risk of socioemotional behavioural problems and low risk of criminality. Multivariable logistic regressions assessed the association between these trajectories and the outcome variable, the PSM, while adjusting for confounders.Results Our analysis identified six adversity trajectories: low poverty and adversity, persistent poverty, persistent poor parental mental health, persistent parental alcohol use, persistent domestic violence, and combined poverty and poor parental mental health. PSM achievement varied across these groups: low poverty and adversity (45.6%), persistent parental alcohol use (49.5%), persistent domestic violence (40.6%), persistent poor parental mental health (35.1%), persistent poverty (22.8%), and combined poverty and poor parental mental health (16.9%). Children with persistent poor parental mental health had 33% lower odds of achieving PSM compared to the low poverty and adversity group (aOR 0.67, 95% CI: 0.58–0.78), those in persistent poverty had 60% lower odds (aOR 0.40, 95% CI: 0.34–0.47), and those with combined poverty and poor parental mental health had 72% lower odds (aOR 0.28, 95% CI: 0.23–0.35). No significant associations were found for children in the persistent substance misuse or the persistent domestic violence groups.Conclusion Our findings show how children exposed to persistent poverty and poor parental mental health face significant barriers to achieving positive social mobility milestones. These findings highlight the need for targeted public health interventions to address these challenges and improve outcomes during the transition to adulthood.