The Trump administration’s gutting of USAID has dismantled US-driven bilateral humanitarian assistance, done historically through the Bureau for Humanitarian Assistance (BHA). In this paper, I explore the implications of cutting BHA by explaining the history, bureaucracy, and principles that drive the agency’s work. Furthermore, I articulate three case studies that reflect the unique role of BHA in responding to different types of disasters overseas. In doing so, I also aim to evaluate the legitimacy and validity behind common criticisms that have been levied against foreign aid as an institution and USAID. Twelve interviews with former USAID-affiliated officials and employees offer insider accounts of the type of rapid response and diplomatic coordination that will be lost in the future. While BHA’s work in the humanitarian space is imperfect, the Trump administration’s sudden dismantling of USAID has sown chaos in many regions of the world, directly contributing to human casualties and deaths. The future of humanitarian assistance as we know it hangs in the balance.