This study examines kinship care of orphans throughout China. It finds that in addition to children becoming orphaned if both parents die, some children are treated as orphans when their father dies and rural traditional kinship care obligations restrict the viability of widowed mothers continuing to care for their child. When mothers are forced for socioeconomic reasons to leave the paternal extended family, children effectively become orphans, dependent on ageing grandparents. Girls and disabled children are most at risk. Implementing financial and other support to orphans, widowed mothers and kinship carers could improve the sustainability of these family relationships.