This chapter shows that, although the Inter-American Development Bank (IADB) mandate remained unchanged over the course of over fifty years from its creation, the Bank’s lending policies in Latin America changed over time, consistent with the prevailing policy framework in developed countries. Unlike in other multilateral development banks (MDB) with a presence in the region—especially the World Bank—Latin American countries played a bigger role in the IADB’s decision-making process from the very moment the regional bank was created. However, donor countries, in particular the United States, enforced IADB policy guidelines, with a varying degree of conflict over the different periods. The authors establish that the institution underwent a transition phase, which began in the 1980s, marking a move away from a developmental role associated with state-led industrialization processes. The IADB became a supporter of liberalization and deregulation policies in the 1990s and then, from the 2008‒9 global crisis, played a new active role for development.