Globally the number of orphans has been increasing and currently stand at 153 million. The increase is due to war, HIV and Aids, and migration among others. South Africa recorded 631000 double orphans in 2015. Only two-thirds of children in South Africa have been perceived to have positive health by their caregivers. Although a vast number of studies have focused on the mental health of orphans who are raised in grandfamilies in South Africa, there is a dearth of literature that investigates the physical health (in particular, disease outcomes) of double orphans raised in grandfamilies in South Africa. The study examined the levels and socio-demographic characteristics associated with disease outcomes among double orphans (0-14 years) raised in grandfamilies in South Africa, 2017. The study used the National Income Dynamic Study 2017 data. Prevalence of disease was calculated and multinomial logistic regression was run using STATA version 14. Only 6.57% of children aged 0-14 years in South Africa were double orphans raised in grandfamilies in 2017. The study found 93% of double orphans to be in good health. More double orphans showed to have acute diseases as compared to those with chronic diseases(5% and 2% respectively). Sex of double orphans [RRR 4.609 CI 1.003 –21.183], perceived health status [RRR 0.054 CI 0.006 –0.445], [RRR 0.026 CI 0.002 –0.407], and health check-up in the last year [RRR 0.008 CI 0.001 –0.106], [RRR 0.13 CI 0.002 –0.032] proved to be significant predictors of the health outcomes of double orphans. Double orphans are more at risk of having acute and chronic diseases verses having no disease. The study concluded that the socio-demographic and health characteristics of double orphans affect their disease outcomes. Further research needs to be done on the health outcomes of double orphans raised in grandfamilies in South Africa, and social grands need to be accompanied by other social services