In 2005 BBC Films acquired the rights to adapt the book as a film. Director Lynne Ramsay signed on to direct. It was announced in March 2009 that Tilda Swinton had signed on to star in the film as Eva. Filming began on location in Stamford, Connecticut on April 19, 2010. We Need To Talk About Kevin was screened at the Toronto International Film Festival on September 9 and 11, 2011. John C. Reilly plays Franklin and Ezra Miller plays Kevin. The film premiered In Competition at the 2011 Cannes Film Festival, where it was met with praise from film critics.
From January 7, 2008, the story was serialized on BBC Radio 4 in 10 15-minute episodes and was broadcast daily as the Woman's Hour drama. It starred Madeleine Potter as Eva Katchadourian. Ethan Brooke and Nathan Nolan played Kevin at various ages, while Richard Laing played Franklin Plaskett. It is occasionally repeated on BBC Radio 4 Extra.