Community health workers possess valuable insight into the experiences of South Africa's children and caregivers. However, their knowledge is often overlooked in efforts to understand local realities, inform interventions, and develop relevant policies. This study aimed to explore community health workers' perspectives of the first 1000 days of life, the critical period of development between conception and two years of age. Semi-structured interviews were conducted with 15 community health workers working with mothers and infants in Khayelitsha, Cape Town. A thematic analysis suggests that the community health workers view the first 1000 days as fundamental and foundational for children's development. Furthermore, the community health workers identified key needs for mothers/caregivers and infants within the first 1000 days. The findings provide contextual grounding for the importance of the first 1000 days within South African communities.