AIDS, in interaction with other factors, is impacting on the livelihood activities, opportunities and choices of young people in southern Africa. This article explores these linkages firstly by reviewing what is known about the impacts of AIDS on young people, before looking more specifically at how this impinges on their future ability to secure livelihoods. Within the home and family, AIDS often results in youth taking on a heavy burden of responsibilities. This can include caring for sick relatives, helping with chores and taking on paid employment. This burden of care and work can have further impacts on young people's future livelihoods as they find they have reduced access to schooling, potential loss of inheritance and a breakdown in the intergenerational transfer of knowledge, which is especially important for sustained agricultural production. The article ends by suggesting that the sustainable livelihoods approach can be useful for understanding the complexity of the issues surrounding the impacts of AIDS on young people's livelihoods and calls for further research to explore how their access to future sustainable livelihoods in rural southern Africa might be supported.