This study examined the short-term impacts of COVID-19-related orphanhood on children and adolescents in peri-urban Khayelitsha, South Africa, finding that those who lost a parent or primary caregiver experienced significantly greater mental health burdens, food insecurity, caregiving responsibilities, and engagement in social risk behaviours compared to peers without such loss. These findings highlight the heightened vulnerability of affected children and underscore the urgent need for targeted interventions and planning to support their wellbeing and development during and after crises.