This article uses empirical evidence from Latin American and East European International Monetary Fund (IMF) programs from 1982 to 2001 to analyze the nature and the extent of preferential lending practices by the IMF. Unlike prior work, which focused on narrow political interference from large IMF member states, the present analysis differentiates between such narrow interests and the Fund’s international systemic responsibilities, which may justify the preferential treatment of systemically important countries to prevent broader regional or global crises. The empirical results suggest that systemically based deviations from technocratic impartiality predominate in situations—such as the Latin American debt crisis—where international financial stability is under serious threat. Under such circumstances, economically important countries do receive preferential IMF treatment but only when experiencing severe crises, while narrow “private goods” considerations are largely sidelined. When systemic threats are less immediate—such as in Latin America and Eastern Europe in the 1990s—IMF favoritism reflects a more volatile and region-specific mix of private and public considerations in line with the changing interests of powerful Western nations in the developing world.