Based on the pre-war, war and post-war experiences of social work and social welfare reform in south-east Europe, particularly the former Yugoslavia, the authors reflect on the reasons for some of the paradoxes regarding the politicisation of social work over the past two decades, given the centrality of political factors in both the conflict and post-conflict environments. The text explores the often neglected history of social work and social welfare in former Yugoslavia prior to the 1990s. It then addresses the dominance of ‘psycho-social’ and medicalised approaches to welfare during the war and, finally, examines the role of international organisations in supporting welfare reform in the post-war period. The latter two periods include examples from the authors’ own practice. Based on these experiences and the available literature, the text emphasises the need for a longer-term engagement in war and post-war communities, based on practices that build alliances between social workers, community activists and service users.