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This paper examines the effects of structural adjustment lending on governments ’ policy choices. Prior research has focused largely on the effects of IMF stand-by agreements on economic growth generally. But the literature has largely neglected a prior step in the causal chain: the effects of adjustment lending on policy choice. And previous scholarship has also paid less attention to the role played by other international financial institutions, including the World Bank, and even more neglected are the roles potentially played by the regional development banks and by bilateral financing. We address both of these issues by using comprehensive data from the Project-Level Aid Database (PLAID), which includes data on adjustment financing from multilateral banks as well as from bilateral sources. We also employ multiple measures of policy reform, including inflation, exchange rate stability, and size of budget deficit. We find that structural adjustment projects do not typically translate into policy reform