This paper examines the role of non-governmental organizations (NGOs) in service provision with a special focus on Sub-Saharan Africa and Asia. First, it reviews the conceptual and taxonomic issues in NGOs. It then proceeds to examine the performance of NGOs in some countries. The paper notes the increased relevance of NGOs in many countries. It, however, argues that any expectation that the NGOs will supplant the state in service provision is likely to be utopian. It contends that just as we have government failure and market failure, we can also have third sector failure. The paper argues for an appropriate balance between the state and NGOs in meeting the needs of the poor. It concludes that while it may be necessary to continue to strengthen the private sector and the third sector, it would be useful to continue to inquire into how the state can be effective.