The United Nations Relief and Works Agency (UNRWA) was established in response to the refugee crisis caused by the 1948 Arab-Israeli conflict in the Middle East. UNRWA was mandated to provide humanitarian relief and employment for Palestine refugees. Today, UNRWA provides support to 4.9 million refugees in Gaza, Jordan, Lebanon, Syria and the West Bank. The Department for International Development (DFID) is UNRWA’s fourth largest donor, contributing £173.2 million in the period 2008-12. This review assesses the impact that DFID’s support has on Palestine refugees and the effectiveness of DFID’s engagement with UNRWA. The review focusses on UNRWA’s provision of health, education and social support to refugees in all locations, except Syria.