The South African state awards unconditional means-tested cash transfers to the caregivers of some eight million poor children. Amidst increasing demands on the state for social assistance, the question has been asked: should the Child Support Grant (CSG) be made conditional on education or health related behaviour to enhance its effectiveness? Issues relating to the popular Latin American conditional cash transfer programmes for children are summarised. The history, current reach and impact of the CSG are described, as well as administrative strengths and weaknesses in delivery. We argue that, to be in line with South Africa’s Constitution, the structural problems of the supply side of education and health provision should be addressed, as well as problems with the delivery of the CSG, rather than considering whether to impose conditionalities that could further exclude poor children and their caregivers from this modest but vital form of support.