This study explored the psychosocial issues faced by children and adolescents with HIV in Botswana. Data on psychosocial issues were collected from 27 young children aged 5-9 years and 128 adolescents aged 10-19 years (n = 155). Data were analysed using Microsoft Excel 2007 and MiniTab16. The most frequently identified psychosocial issues were behaviour problems (70%), family issues (58%), and HIV medication adherence (57%). Compared to young children, adolescents were more likely to have HIV medication adherence issues. Missed appointments were most commonly attributed to patient forgetfulness (21%) and conflicting appointments (18%).