The University of the West Indies (UWI) Faculty of Medical Sciences (FMS) at Mona, established in 1948, has had a long history of improving the lives of Caribbean people, including its children, through teaching and training of medical staff, research and intellectual leadership and public service. Similar to the history of child health development worldwide, the most rapid advances occurred subsequent to the establishment and development of a Department focussed on the needs of children. The FMS staff were initially expatriate lecturers and general paediatricians who trained Jamaican and Caribbean graduates. In 1972, 24 years after the establishment of the UWI and the FMS, the Paediatric Department was fully staffed by Caribbean nationals for the first time. Today, the Department of Child and Adolescent Health at the Mona Campus has almost every recognized paediatric subspecialty among its current staff of Caribbean nationals. The intake of undergraduate medical students moved from 33 in 1948 to 380 in 2013. Undergraduate training was the initial focus of the new university, but when the need for postgraduate training was, the UWI responded and postgraduate training commenced in 1969, some 21 years into the life of the Faculty. Postgraduate medical training was pioneered by the Department of Paediatrics. Postgraduate paediatric training, initially only available at the Mona Campus, was later extended to other Caribbean countries. This paper reports on the development of a Department of Child and Adolescent Health, with a focus on the development of undergraduate and postgraduate teaching and training programmes and their impact. Departmental successes and challenges in this area are also discussed.