In this paper we examine the use of organisational development (OD) as a tool for the achievement of the reform and development goals in Bhutan. We review the reform agenda in Bhutan to identify the goals of reform and then investigate the OD literature to answer the question of whether this is an appropriate tool for achieving these goals. We find that there is considerable potential to use OD in the pursuit of the multi-level goals and, in fact, there is a high level of ‘fit’ between the principles and values of OD and the stated reform agenda in Bhutan. However, we argue that the implementation of this approach is problematic and several tensions are emerging. These tensions have the potential to undermine both the OD approach itself, and the ability of Bhutan to use OD in achieving a complex set of organisational and social goals. Given the unique development approach of Bhutan, we believe this represents a lost opportunity for using OD to achieve significant social outcomes.