Discusses the pros and cons of spontaneous host country foster care and the criteria applied to determinations of appropriate placements for unaccompanied refugee children. Host country foster care enables children to live outside of refugee camp confinement and to receive care and support within a family usually motivated by altruism; however, the spontaneous and voluntary nature of this arrangement means that little if any monitoring occurs. While repatriation is the preferred solution for unaccompanied refugee children, it is not always immediately feasible. In these cases, the guiding principle of placement decisions must be the best interests of the child, which includes not only continuity in ethnic, religious, linguistic, and cultural background, but also freedom from physical or mental violence, maltreatment, sexual and economic exploitation, and other hindrances to a child’s all-around development. Spontaneous host country foster placements should be avoided. If a determination about a child’s best interest dictates that the child should be removed from a foster family, this should be completed in a sensitive but expeditious manner. Children who are given a long-term placement with host country foster families should have their legal status regularized.