Haiti is still recovering from the effects of the massive 2010 earthquake that destroyed much of its infrastructure. While a large international humanitarian response was mounted to save lives and rebuild the country, international nongovernmental organizations have failed to meet many of their most important and relevant objectives in the last four years. Nongovernmental organizations operate within a precise set of legal, economic and political restrictions that have variously been described as too lenient and too obstructive. This paper seeks to examine the governing aid framework in order to describe how a specific combination of limitations and liberties have resulted in organizational imperatives that obfuscate the economic origins of humanitarian financiers, limit aid transparency, reduces NGO accountability to both donors and recipients and lead to poor overall development outcomes. To demonstrate these outcomes this paper uses detailed case studies of three large nonprofit organizations operating in Haiti: Partners in Health, Save the Children and CARE. The objective is not to assume that these are perfectly representative outcomes of aid, but rather to show a variety of development outcomes that the aid apparatus either allowed for or failed to prevent.