How should governments approach the challenge of strengthening PFM systems? This is a question that has dominated the debate on the international support for PFM reforms in lower income countries since the 1990s. This debate exposes a tension between the desire to identify and adopt “best practices” from advanced economies, and suggestions that governments must first “get the basics right”. This chapter looks back over these debates, using a comprehensive review of the published literature. It finds broad agreement that PFM reform in low-income countries should focus on the basics of PFM. However, the literature stops short of providing a clear benchmark for what is “basic enough”. Attention has also shifted away from technical discussions to ask how to get the “process right” for implementing PFM reform.