The South African state awards unconditional means-tested cash transfers to the caregivers of some eight million poor children. Amidst increasing demands on the state for social assistance, and given the positive performance of conditional cash transfer programmes in Latin America, a salient policy question is: should the Child Support Grant (CSG) be made conditional on education or health related behaviour to enhance its effectiveness? The term ‘conditionality’ is used inconsistently in South Africa, and the article suggests separating out five categories or requirements for access to and continued receipt of social grants. We summarise the generally positive performance of conditional cash transfers in diverse Latin American programmes, showing in particular their marked effects on school attendance. The history, current reach and early impact of the CSG are then described. Using the five categories of administrative action, we describe how in the implementation of the unconditional CSG, a range of measures has been imposed which impose costs on applicants, and act to exclude poorer children and caregivers. Further, access to health and education appears to be a supply-side problem, rather than a problem of individual motivation. To be in line with South Africa’s Constitution, better administration and provision is likely to be a more rational, just and efficient intervention than the imposition of conditionalities.