The study analyses the factors behind the growth of health expenditure in Lesotho over the period 1980 to 2011. The cointegration test results reveal that income is one of the important factors explaining the growth of health spending in Lesotho, with public health expenditure being more responsive to changes in income than private health spending. Although the government’s role in disease patterns may be overshadowed by increased external funding, the findings highlight that Lesotho is still committed to improving the overall healthiness of its people. On the other hand, public and private health expenditure are found to follow different paths, with the ability of the citizens to finance their healthcare needs reducing the government’s pressure to offer more health services. External aid programmes also seem to have impacted positively on Lesotho’s public health spending while reducing a burden for privately-financed health services.