This article presents a case-controlled study that estimated the prevalence of disabilities in HIV-infected and HIV-uninfected children in Lilongwe, Malawi, examines types of disability and associated clinical and socio-demographic factors and identifies needs, opportunities and barriers for rehabilitation in Malawi. This study reveals the magnitude of disability among HIV-infected children and the large unmet need for rehabilitation services. It recommends that this expanding issue is investigated further to provide an evidence base for holistic care for disabled children living with HIV