The HIV and AIDS epidemic is deemed the single greatest threat to South Africa's future and its growth is one of the most rapid in the world. The South African government has marked 2006 as the year of accelerated HIV and AIDS prevention. It has become imperative that school leaders empower themselves in order to meaningfully deal with HIV and AIDS issues within the realities of the South African context. School principals are strategically situated to play a significant role in the struggle against HIV and AIDS in large school communities. The data were gathered in six schools in the Western Cape. This study aimed at gaining an understanding of the challenges facing school principals and of the unique role they could play in addressing the HIV and AIDS epidemic. This study therefore explored, with a view to understanding, the perceptions of principals, parents, learners and HIV and AIDS school and Education Management Development Centre (EMDC) co-ordinators in respect of the role of the school principal.