This article focuses on the problems encountered in the design and implementation of large-scale development projects sponsored by the US Agency for International Development (AID). The analysis aims at resolving the following most critical and common problems: macro constraints, institutional realities, personnel constraints, technical assistance shortcomings, decentralization and participation, timing, information systems, differing agendas, and sustainability. The material presented in drawn from recent development experiences in the Third World. The solutions proposed emphasize several factors including the importance of policy dialogue, institution-building, resource mobilization, creation of local capacity, and the financial aspects of sustainability. But these recommendations are proposed as guidelines rather than blueprints, since project design and implementation are often more art than science, relying as they do on commitment, flexibility, innovation and, above all, a belief in human progress.