Hundreds of Palestinian NGOs work in the West Bank with millions of dollars and thousands of staff members. Yet they fail to meet public needs and priorities at both the individual and collective levels. This study has set out to investigate the underlying reason for NGO failure despite the availability of resources. The research aims at constructing an alternative theory of NGO governance based on the findings from the field. The findings revealed that NGOs are keen on serving the interests of their founders before serving the public. The executive managements also dominate the governing bodies. The progressive institutionalization of NGOs has not translated into improved performance while strategic planning in these organizations has become a futile exercise, fitting more with donors’ requirements than with public needs and priorities. The research concludes with a call for NGO reform in order to enhance accountability in the non-profit sector. The recommendations made in this book are intended to the NGOs themselves and to other relevant stakeholders, including the public authorities, political parties and donor agencies.