Background Humanitarian organisations commonly identify neglect as a specific form of harm from which children should be protected. However, lack of debate about the aetiology of child neglect has left intact a tendency to assume that it is due to a failure of caregivers. Obscured by this assumption are the role of the humanitarian system in supporting or, indeed, undermining the efforts of primary caregivers. Objective To bring together insights from the literature on child neglect in humanitarian settings with findings from empirical research in the Middle East. Participants and setting Fieldwork involved 38 ‘peer researchers’ from five refugee communities: Sudanese, Somali, Iraqi, Syrian (in Jordan) and Palestinian (in Gaza). These researchers undertook enquiry with a total of around 300 people across their respective communities. Methods 100 interviews. 70 follow-up interviews. Theatre-based workshops and focus group discussions with 30 children. Research workshops with 35 children. Focus group discussions with 40 parents. Creative writing project with 60 children. Results Fieldwork revealed neglect in three distinct areas: educational participation, access to healthcare, and physical safety. This neglect can be related to the humanitarian system, (including humanitarian agencies, host government, donors, etc.), that is both directly neglectful and undermining of caregivers' efforts. Conclusion Caregivers in our study illustrated the impossibility of exercising constant vigilance over children within conditions of extreme social and economic marginalisation. Thoroughgoing debate about child neglect is needed to address this situation and ensure that caregivers receive adequate support to meet their children's needs. Such support should be offered in a manner that upholds the dignity of displaced people - adults and children alike.