Background: This article examines the development of early childhood development (ECD) home-visiting services in South Africa. Aim: To examine the factors that could support the success of home-visiting programmes as well as to explore the experiences of bachelor's-level home visitors rendering such services. Setting: This study was conducted in the Eastern Cape, a highly impoverished area of South Africa. Methods: It begins with a discussion of the emergence of home-visiting as a strategy for the delivery of ECD services in South Africa and a review of the literature on ECD home-visiting, particularly with highly vulnerable, impoverished families. Next a focus group conducted with a small sample of home visitors as part of a multi-faceted community assessment is described. The results are examined within the context of challenges facing this particular part of South Africa and the nation as a whole. Results: Four themes emerged as most prominent: (1) encountering the effects of extreme family poverty, (2) identifying high rates and multiple aspects of child maltreatment, (3) encountering scarce resources in high-need areas and (4) finding rewards and maintaining a desire to continue serving challenging populations. Conclusion: This study provides a unique window on the challenges that ECD home visitors are likely to encounter when working with families living in extreme poverty, the resourcefulness that home visitors often demonstrate and the rewards to be found in this work.