This chapter explores the International Monetary Fund (IMF)’s responsibilities in the international debt architecture, including analysis, debt crisis prevention, and resolution. The chapter argues that low-income and emerging market countries’ historically high debt levels and risks will impact the institution. Looking at how debt concerns already inspired changes in the past, it identifies the three areas where these impacts are likely to be more noticeable: concessional funding and debt relief, debt sustainability assessments, and the IMF’s role in sovereign debt restructurings. The chapter identifies challenges for each and examines how the challenges may affect the IMF’s path of evolution.