The financial power of philanthropic organizations like the Bill and Melinda Gates Foundation has raised questions about the intersection of philanthropy and global health. This chapter examines how and whether philanthropy has an effect on the global health agenda. It begins by defining philanthropy and exploring how philanthropy operates in international relations, philanthropy’s historical role in global politics, and its relationship to larger power dynamics. The second section identifies key global health philanthropic actors and their roles in global health governance. The third section describes the potential positive roles that philanthropic organizations can play in global health, bringing new ideas and additional resources. The final section critiques the relationship between philanthropy and global health, paying particular attention to how financial clout could distort the global health agenda and whether philanthropy covers up larger structural imbalances that give rise to health problems.