Introduction: Missed opportunities exist for early detection of HIV infection in children visiting healthcare institutions. Provider Initiated Testing and Counselling (PITC) Strategy is a means for reducing missed opportunities for children who are HIV exposed or infected. It enhances the access of such children to HIV preventive measures, care interventions and treatment. There is a gap in knowledge concerning the acceptability of the PITC strategy in detection of HIV infected or exposed Nigerian children, most especially Children from Ekiti state. Aim: To determine the acceptability of PITC Strategy for HIV testing among caregivers of children seen at the Paediatric Emergency Unit of FMC, Ido-Ekiti, Ekiti State and the factors that influenced acceptability. Materials and Methods: This was a prospective, hospitalbased cross-sectional study on acceptability of HIV testing using PITC model. Consecutive caregivers of patients attending the PEU for the first time aged 6 weeks to 15 years were offered HIV testing using WHO guideline on PITC. Pre-test and posttest information were provided in individual sessions. Those whose HIV status was already known were excluded from the study. Data were analysed using Statistical Package for Social Sciences (SPSS), version 15.0. Results: A total of 530 (97.6%) out of 543 caregivers counselled for HIV testing gave consent for the test. The age range of the caregivers was 19-56 years with a mean of 30.2 (±6.8) years. The predominant group of caregivers in attendance were mothers only accounting for 504 (92.8%) of the total 530 caregivers studied. Acceptability rate was inversely associated with the level of education and social class of the caregivers. A total of 348 (99.4%) out of 350 caregivers whose wards required admission accepted testing, while 182 (94.3%) out of 193 caregivers whose wards did not require admission accepted testing. This difference was statistically significant (p=0.001). Conclusion: Acceptability rate for HIV testing, using PITC Strategy was high in all the age-groups of the caregivers; acceptability rate was however inversely related to the level of education and social class. [ABSTRACT FROM AUTHOR]