This chapter looks at the evolving use and understanding of 'conditionality'. There have been deep divisions over the understanding of this term, between those who have seen it as 'an instrument of mutual accountability' and those who viewed it as a tool of financial leverage, forcing governments to do what they would otherwise not have done. In recent years, however, many of these divisions have narrowed as both governments and International Financial Institutions have gravitated towards a more agreeable middle-ground. This paper asks what has changed and whether this streamlining has succeeded.