Based on ethnographic fieldwork in Lusaka, Zambia, this article puts forth the concept of imaginal caring to examine a form of caring that is fantastical, exaggerated, and counterfactual. To develop this concept, I take the vantage point of young children (ages eight through twelve) who lived in households with persons who were suffering from tuberculosis and HIV. The children were involved in providing day‐to‐day care in many ways. They were also constrained in their efforts to give and show care because of their social positions, their access to resources, and their small human bodies. Through a series of examples, I demonstrate the ways in which children created and played with often visual images of giving care to family members in the past, present, and future. I show that fantastical imaginations and images of children's involvement in caring not only expressed that they cared for others but also served as ways for them to provide or perform care. There were high social and personal stakes for children in not being able to care for others, and children's efforts to care imaginally responded to such stakes, envisioning futures different from those scripted for them by global health discourses and the conditions of marginalization and exclusion into which they were born.