Based on fieldwork in Knoxville, Tennessee, I analyze the ethical dilemmas of conservative evangelical Protestants engaged in faith-based activism and social outreach, especially dilemmas stemming from the theological paradox of compassion and accountability. Evangelicals who minister to the poor and distressed must reconcile romanticized notions of pure sacrificial giving with an ideology of personal responsibility inherent in their concept of accountability. Socially engaged evangelicals struggle with competing moral ambitions and religious imperatives that derive meaning from an overarching rubric of Christian evangelism, in which gifts of divine grace are seen as creating reciprocal obligations as well as insurmountable debt on the part of recipients. The outreach efforts of suburban churchgoers are further complicated by unequal power dynamics between charitable givers and charity recipients. While exploring the complexities of a vernacular theology through which socially engaged evangelicals wrestle with these issues, I discuss theoretical and political implications of the case study, including the role of activism in shaping religious identities and the resurgence of religious conservatism in U.S. civil society and public culture.