Objective: Afghanistan has witnessed a long-lasting 4-decade armed conflict, which together with high levels of poverty and interpersonal violence, resulted in high incidence and prevalence of mental disorders in general population, including children and adolescents. Until mid-2018, there was neither mental health care facility nor a child psychiatrist in Afghanistan. Here, we report the establishment of the first children and adolescents’ mental health center (CAMHC) in Herat province of Afghanistan. Methods: In July 2018, CAMHC was initiated at Mental Health Training Center – Herat. CAMHC was initially planned by the International Assistance Mission (IAM) and Herat Public Health Directorate; and financially supported by the Tearfund UK, the United Methodist Committee on Relief and Tearfund Australia. The target population of CAMHC was children and adolescents in Herat and neighboring provinces, healthcare professionals, staff of government and non-governmental organizations, school teachers and community leaders. Results: A group of eight mental health professionals were trained and made the interdisciplinary board for diagnosis and management of mental disorders in children and adolescents. During the initial three-year period, 2 448 patients, including 1 264 (51.6%) boys and 1 184 (48.4%) girls, presented with mental disorders to CAMHC. Diagnosis and management of mental disorders were performed according to standard international protocols. Eighteen awareness-raising seminars were held; 2 000 leaflets, 10 000 posters, and 30 000 brochures were prepared and distributed; and two short video clips were produced and broadcast via IAM website, social media and local TV channels. A database was developed to house for project data, assessment of outcomes and reporting to stakeholders. Conclusion: Establishment of CAMHC resulted in significant achievements in diagnosis and management of mental disorders among children and adolescents, healthcare staff capacity building, and awareness-raising about mental disorders. Data obtained in CAMHC offers government, mental health professionals and the community the opportunity of improving mental health in the region.