Lesotho is a small African country that has introduced two national cash transfer programmes, the universal old-age pension, and the child grant programme. This study indicates that the initiation of the social pension was not the result of cross-national policy diffusion in line with the ‘South African model’, but rather facilitated by a transition to political stability and a dominant government led by then prime minister, Mosisili. The child grant programme for orphaned and vulnerable children was initially driven by international organizations, yet the Lesotho government quickly took ownership of the initiative. Unlike in many other parts of sub-Saharan Africa, these reforms were not resisted by domestic political elites. Both programmes were rooted in socioeconomic changes such as the HIV/AIDS pandemic, and a political shift after an extended period of political competition, with the (possibly short-lived) restoration of democratic competition in the early 2000s, opening up for programmatic reform.