The HIV epidemic among Ethiopian children appears neglected in national programs (children ART coverage was only 12% in 2013). This paper estimates the country burden of HIV in older children and investigates the prevalence of HIV in orphans and vulnerable children (OVC) households. Our analysis estimated the population of HIV-positive children under 15 years old to be 160,000 in 2013. The majority of children (81.6%) were aged 5 to 14 years. The estimated number of orphans due to AIDS was 800,000. The empirical data from almost 10,000 OVC under 18 years showed 11.9% were HIV-positive, the majority of whom were between 5 and 10 years old with no significant difference between males and females. There is a large population of children living with HIV in Ethiopia, the magnitude of which has not been previously recognized. The majority were vertically infected and never identified nor linked into treatment. OVC represent a reachable group which could account for a substantial proportion of the HIV-infected older children. We recommend that HIV programs urgently synergize with social protection sectors and address these children with HIV testing and related services.