It has been five years since the multilateral development banks (MDBs) adopted a new initiative, the Agreement for Mutual Enforcement of Debarment Decisions (AMEDD). The AMEDD enables the MDBs to recognize and enforce the sanctions decisions of other institutions participating in the AMEDD, thereby multiplying the effect of one institution’s sanctions on a debarred party. The AMEDD has been subject to legal tests that have called into question the sanctions processes of the MDBs. This article assesses challenges faced by the MDBs when implementing the AMEDD, the range of sanctions actions taken, enforcement trends, and the impact of sanctions—particularly cross-debarment—on corporate entities and individuals. In the past five years, the MDBs have faced significant challenges to their sanctions regimes while attempting to combat fraud and corruption and to increase good governance practices and investments in their MDB programs and economies. Given the lofty goals of the AMEDD, it is timely to consider whether it has met these goals and what its achievements have been.