Beliefs about child illness were investigated using semi-structured interviews with mothers and providers in four rural Guatemalan communities. The two most common forms of child illness in Guatemala – diarrhoea and respiratory disease – were focused upon. These illnesses are particularly difficult to prevent and treat, especially with the rudimentary health services available in rural areas of developing countries. Comparisons with other ethnographic studies in Guatemala suggest that some traditional models of illness causation identified in these earlier investigations are relatively unimportant in the communities studied here. This finding, in conjunction with frequent responses related to hygiene and water, suggests that traditional explanations may be co-existing with biomedical views of illness causation to a greater degree today than in the past.