Objective: To determine the prevalence of psychiatric disorders and the factors associated with child psychiatric disorders among children living in orphanages, Kota Bharu, Malaysia. Design: This study utilizes a two-stage study design. Materials and Methods: All children and adolescents living in orphanages were screened using the self- and teacher-rated, Malay version. Strength and Difficulties Questionnaires (SDQ). All children and adolescents identified as high-difficulties (extreme 10% of the population) and randomly selected cases of children identified as low-difficulties (90% of the population) were interviewed for diagnoses using ICD-10 diagnostic criteria. Results: Self-rated and teacher-rated SDQ reported the prevalence of 12% and 11% children at higher-difficulties and 88% and 89% at lower difficulties respectively. Being male was the only risk factor found to be associated significantly with a high difficulty group. Similarly, self-rated and teacher-rated SDQ reported the prevalence of psychiatric disorders among children living in orphanages in Kota Bharu, Malaysia was 10.9% and 8.2% respectively. Conclusion: This study illustrates that children living in orphanages have a similar prevalence rate of psychiatric disorders with adults living in the community. There is a need for early recognition of psychiatric disorders.