The issue of premarital childbearing has been a concern of many analysts in southern Africa. This paper looks at the situation of premarital childbearing in Lesotho in comparative context with the neighbouring countries. The total fertility rate (TFR) estimated from the 1996 population census of Lesotho for all women combined was 4.1 births, a decline from a TFR of 5.5 in the mid-1970s. Only a small proportion of births in Lesotho are born out-of-wedlock. The Lesotho Safe Motherhood Initiative Survey data of 1995 found that only 3 per cent of never married Basotho women aged 15–19 had given birth; a very much lower rate than in Botswana where the rate was 21 per cent. There are a number of factors that influence the relatively low incidence of premarital, adolescent childbearing in Lesotho. It is argued that one factor is that, despite significant social change, Sesotho culture is still generally opposed to such pregnancies. Local derogatory names are given to children born out-of-wedlock, and their mothers are still referred to as 'spoilt' or 'destroyed' in order to discourage such behaviour. The strength of such stigmatisation appears to be much less, or negligible, in neighbouring countries. There is a growing tendency to separate motherhood from marriage in many societies in the region and in some cases having a child can increase the chance of marriage. In Lesotho, the culture against premarital sex is changing as well, and a substantial number of adolescent females conceive before marriage. It appears that a significant proportion resort to illegal, unsafe abortions and the government needs to be aware of these changes in the behaviour of adolescents and their needs.