Beit Cure International Hospital (BCIH) is a specialist orthopaedic hospital providing surgical services to the children of Malawi. The hospital started treating patients in late 2002, and this analysis represents an attempt to assess the impact of the hospital, and develop strategies for future partnerships and development. Analysis was made of all the 563 case files of new patients treated operatively in the fifth year of hospital services. Data recorded included district and region of origin of patient, diagnosis, age and sex. Patients were treated from all 3 regions, with almost 50% coming from Southern region. Club foot, burn contracture, and genu varus were the most common diagnoses. Half the children were infants up to 5 years of age, while 60% were male. The underlying reasons behind these findings are analysed and their implications in terms of future hospital strategy are discussed.