This Opinion Note continues the discussion started in Antonio Donini and Daniel Maxwell's “From Face-to-Face to Face-to-Screen: Remote Management, Effectiveness and Accountability of Humanitarian Action in Insecure Environments”, published previously in the Review, by exposing the realities of Médecins Sans Frontières' (MSF) struggle with the issue of remote management. By reviewing MSF's experience with remote management in Somalia and Afghanistan, the authors explore how operational compromise evolves over time, based on specific contextual factors, and highlight the challenges that this form of compromised action poses to MSF's identity and principles.