The first part of this presentation reviews the record, in a quantitative manner, of IMF programs in Southeastern Europe (not including Greece) over the past ten years. It also examines the evolving nature of IMF access (scale of financing) and conditionality in the region over this period. The second part of the presentation will attempt to answer the question why technical assistance often fails. An attempt will be made to extrapolate some general principles from the author’s experience of working in Southeastern Europe. What does and does not work, and why?