This chapter examines the causes and consequences of state-building in the Middle East region. It offers a theoretical and conceptual framework to analyze state-building and its challenges and dilemmas. It then adumbrates the recurring dilemmas of state builders: they need to concentrate power at the centre, monopolizing it at the expense of rivals; but they also need to expand power, incorporating social forces which otherwise may be mobilized by opponents. This delicate balancing act seldom wholly succeeds; to the extent regimes’ authority remains contested, states are vulnerable to intervention from without by rivals powers. Hence internal instability and the regional power struggle interact.