Aim: To describe household change over a 10-year period of tremendous social, political, economic and health transformation in South Africa using data from the Agincourt health and demographic surveillance system in the rural northeast of South Africa. Methods: Examination of household structure and composition at three points: 1992, 1997, and 2003. These three years loosely represent conditions immediately before the elections (1992), short term post-elections (1997), and longer term (2003), and span a period of notable increase in HIV prevalence. Results: Average household size decreased and the proportion headed by females increased. The within-household dependency ratios for children and elders both decreased, as did the proportion of households containing foster children. The proportion with at least one maternal orphan doubled, but was still relatively small at 5.5%. Conclusions: This analysis is a starting point for future investigations aimed at explaining how HIV/AIDS and other sociocultural changes post-apartheid have impacted on household organization. The analysis shows both consistency and change in measures of household structure and composition between 1992 and 2003. The changes do not include an increase in various types of “fragile families”, such as child-headed or skipped-generation households that might be expected due to HIV/AIDS.