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Objectives Different models of early identification and intervention for autism are linked to best developmental and educational outcomes in children but are difficult to access in most low- and middle-income country settings (LMICs). To support the substantial number of children being referred for assessment to tertiary services in Cape Town, South Africa, a team of developmental paediatricians and therapists from the Red Cross War Memorial Children’s Hospital (RCWMCH) initiated an outreach service at Victoria Hospital, a large metro district hospital.Methods After discussions amongst the key-stakeholders within the health system, both hospital teams initiated an outreach clinic where doctors and therapists identified specific needs of families and children living with autism.Results The team comprised of a developmental paediatrician, four paediatricians, four occupational therapists, two speech therapists and a behavioural therapist together with neurodevelopmental trainees from Ghana and Uganda. Two multidisciplinary group consultations were run concurrently with case presentation, child assessment, discussion and parent feedback. Complexities included difficult diagnoses, challenging counselling, complex behaviour, comorbidities, medication, educational support and socioeconomic impacts. Multidisciplinary strategies were documented on specific case sheets. The outreach strengthened care for children in the community, reducing waiting times management whilst building knowledge, communication and access to local support organizations. The team committed to two new clinics a year to sustain the outreach.Conclusions Challenges in LMICs determine how we deliver services within a resource constrained system. Strategic outreach partnerships can timeously address the needs of families and children living with autism and strengthen health care systems.