The article examines the determinants of the government’s approval in responding to the COVID-19 outbreak in the MENA region. A preliminary examination of public opinion polls demonstrates that trust in the government is the major determinant of satisfaction with the government’s handling of the crisis. In addition, the government approval improved over time in some countries challenging the rallying around the flag explanation. The impact of economic insecurity is mixed and inconsistent across the countries of the MENA region. In countries with an economic crisis such as Lebanon, economic hardship resulting from the pandemic affected the government approval of the crisis. Yet, in other countries, economic insecurity does not impact the government’s approval of the crisis. The findings of the article have important implications for understanding what constitutes effective leadership in addressing the pandemic at the state and regional levels and how external shocks influence state–society relations in authoritarian regimes.