The phenomenon of child-headed households has emerged from an escalating rate of orphanhood resulting from human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). While the issue has received much media attention in South Africa, very little scientific information focusing particularly on the psychosocial experiences of the children has been published. In the present paper 14 children in Gauteng and KwaZulu Natal provinces of South Africa, heading households as a result of HIV/AIDS-related parental death, were interviewed in depth to explore their psychosocial experiences and perceptions. Interpretative phenomenological analysis was utilized to analyse the data. The findings indicate that pre-parental death experiences were characterized by complex experiences of illness in the household. The death of a parent(s) was itself experienced with great difficulty and sense of loss, with a theme of apportioning blame for parental death on other people emerging from the interviews. Post-bereavement, the defining psychosocial challenges included perceived lost childhood and self, sense of abandonment, concerns over day-to-day survival and grappling with conflicting demands on both physical and emotional energy. It also emerged that for some respondents these experiences were aggravated by negative attitudes and treatment from other people in their communities. In the light of these results increased support, including professional attention where indicated, is encouraged.