A consistent theme in the literature on interventions for orphans and vulnerable children is the need for community-based care. However, a number of sociocultural factors may impede community response. In this study, mixed methods are used to elucidate community-level barriers to care for orphans and vulnerable youth in Rwanda. Data from a large survey of youth heads of household on perceptions of marginalization from the community and the factors which predict that marginalization are considered in light of additional data from a survey of adults who volunteer to mentor these youth and focus groups with both community adults and youth heads of household. Results highlight how orphans’ impoverished condition, cause of parents’ death, and community perceptions concerning orphan behavior all play a role in marginalization of orphaned youth in Rwanda. Evidence is also offered as to how targeting humanitarian assistance to vulnerable youth may inadvertently lessen the level of community support they receive and contribute to their marginalization. The implications of these data for community-based program approaches are discussed.