While donors are keen to promote cash transfer-based social protection in sub-Saharan Africa, and have promoted and financed a significant number of pilots to this end, such donor-led initiatives have not necessarily resulted in sustained or nationally-owned systems. Where cash-transfer programmes have been successful in the region, they have often been initiated domestically, rather than externally, and many with only limited donor support. This paper reviews recent experiences and draws on a set of commissioned studies exploring cash-transfer programming in Low Income Countries (LICs), to explore the possible reasons for differing government and donor perspectives on the desirability of cash-transfer programming, and attempts to abstract some broad policy insights. The paper highlights issues of national fiscal sustainability, government preferences, and ownership, as the key determinants of large scale government cash transfer implementation. The paper then draws out key lessons for future donor policy and programming in the region.