This paper draws upon development economics theory, demographic projections, and empirical evidence to consider the likely consequences of the HIV/AIDS pandemic for the agricultural sector of the hardest-hit countries of Eastern and Southern Africa. We identify four processes that have been underemphasized in previous analysis: 1) the momentum of long-term population growth rates; 2) substantial underemployment in these countries’ informal sectors; 3) steady declines in land-to-person ratios in the smallholder farming sectors; and 4) effects of food and input marketing reforms on shifts in cropping patterns. The paper concludes that the conventional wisdom encouraging prioritisation of labour-saving technology or crops has been over-generalised, although labour-saving agricultural technologies may be appropriate for certain types of households and regions. The most effective means for agricultural policy to respond to HIV/AIDS will entail stepping up support for agricultural science and technology development, extension systems, and input and crop market development to improve the agricultural sector’s potential to raise living standards in highly affected rural communities. Agricultural productivity growth may also help to overcome poverty-related factors that may interact with the disease to magnify its effects.