Orphanage volunteering (also known as voluntourism or orphan tourism) describes an activity in which short-term volunteers engage in day-to-day caregiving activities with vulnerable children and youth living in residential care. Volunteers (most of whom are from high-income countries) work as temporary caregivers for children (most of whom are in low-income or middle-income countries), typically interacting with them for several hours each day during their visit. Each year, thousands of religious institutions, universities, and non-profit organisations sponsor such volunteer trips. Much of the published research on orphanage volunteering has focused on the effects of the practice on volunteers. We argue that there is also substantial reason for concern about the harm this practice might have on the children—especially in young children (ie, ≤5 years)—being raised in these settings.