In this paper, we examine the success of a non-conditional means-tested cash transfer targeted at poor children under the age of 7 in South Africa. We assess the reach and early impact of the child support grant in the Umkhanyakude District of KwaZulu-Natal. The District is poor and mostly rural. In 2001, 8% of households had piped water inside their dwellings (Case and Ardington 2004) – in contrast to 30% for KZN, and 32% for the country as a whole (Statistics South Africa, Census 2001). Thirty nine percent of households had no toilet facilities on site. Only 50% of households were connected to an electricity grid. The District is bearing a heavy disease and death burden, associated with the HIV/AIDS crisis (Hosegood et al. 2004). Umkhanyakude is thus precisely the kind of area that the Child Support Grant is intended to reach.