This article addresses the role played by Western non-governmental organisations (NGOs) in managing migration, with particular regard to refugees and refugee policy in the modern era. A commitment to the support and welfare of refugees has been a core component of the activity of many NGOs since the late nineteenth century. But this humanitarian purpose cannot be divorced from the prevailing refugee regime. The state acted as gate-keeper, determining who was recognised and protected as a refugee. The issue of funding available to NGOs is also closely linked to state-driven priorities. Nevertheless, NGOs are significant humanitarian actors in their own right. This article considers the proliferation of NGOs and their activities in the broad field of refugee relief. A focus on the evolution, rationale and differentiation of NGOs suggests that we can usefully think of them as enterprises of a distinct kind. Although they are not driven by profit motives, this article suggests that NGOs do have a business strategy in which their efficacy, innovation and accountability to donors are important considerations. It concludes by reaffirming the fundamental point that only in exceptional circumstances were NGOs seeking to assist refugees able to escape the fundamental constraints imposed by the state.