Public-private partnerships (PPPs) have been hailed as ‘one of the most participatory and effective mechanisms to implement sustainable development’ (UN, 2012b, see also Chapter 1). Advocates of this governance form see PPPs as uniquely capable of engaging and mobilizing private and public actors in joint action, and praise both their effectiveness and their efficiency in project implementation. They argue that the project designs of PPPs offer multiple advantages by combining public authorities’ access to governmental organizations in the partner country, the market’s enthusiasm for efficiency and innovation, and the close relations of civil society groups with local populations. Yet, critics claim that such positive assessments are not founded on empirical evidence, raising strong doubts about the alleged innovation and value added by PPP projects. In this chapter, we analyze PPP project design in greater detail, looking particularly at the degree of institutionalization and elements of process and project management in PPPs (see Chapter 2). In doing so, we are interested in determining how and why different elements of project design affect project success or failure in a context of limited statehood. Therefore, the central focus of this chapter is on the question: Which characteristics of project design are the most significant for project output, outcome, and long-term, large-scale impact in areas of limited statehood?