This paper documents water carrying by children aged 9-18 years across Malawi in Southern Africa and evaluates impacts on health and school attendance. At 12 urban and rural field sites quantitative data were collected by questionnaire interviews with 1,504 children. Qualitative data collection preceded the survey. Overall 89 per cent of girls and 66 per cent of boys carried water, with 68 per cent of girls, but just 32 per cent of boys, carrying water daily. Water as the heaviest load routinely carried was reported by 57 per cent of children and 35 per cent reported pains and health problems from load carrying. Up to 10 per cent of girls and 6 per cent of boys responded that carrying water made them late or absent from school. Geography, age, and other factors influence these patterns. We conclude that girls in rural and remote rural communities have the heaviest burdens of daily water carrying detrimental to their health and school attendance. Improving water access and challenging gender stereotyping should reduce burdens on children, especially girls.