In resource poor countries substantial sums of money, from governments and international donors, are used to purchase equipment for health facilities. WHO estimates that 50-80% of such equipment remains non-functional. This article is based on the experiences from various projects in developing countries in Asia and Africa. The key issues in the purchase, distribution, installation, management and maintenance of equipment for emergency obstetric care (EmOC) services are identified and discussed. Some positive examples are described to show how common equipment management problems are solved.