Background and Objective: Although developing countries have been receiving donations of medical equipment for many years, a number of studies have indicated that a high percentage of donated equipment is never put into use. [1,3,4] Many of the reasons for this can be traced back to inadequate donation practices on the part of donor organizations. The objective of this study was to gain an improved understanding of the practices and challenges associated with medical equipment donations by Canadian charitable organizations. Material and Methods: Forty-one organizations (registered and non-registered charities, non-governmental organizations (NGOs), non-profit organizations, medical clinics, and hospitals) completed an online survey, and 16 respondents were interviewed via telephone or in person. In addition, representatives from 28 hospitals in Ghana were interviewed in person to gain an understanding of the recipient experience. Results: We observed that for many Canadian donor organizations there is room for improvement in formalizing procedures, testing to verify equipment functionality before shipping, providing additional support for recipients in the form of manuals, spare parts and training, and long-term monitoring of donated items to measure effectiveness. For recipients, the most common challenges faced were lack of spare parts, and lack of operating or service manuals. Despite these challenges, all of the Ghanaian survey respondents said that donated medical equipment benefited their hospitals. Conclusion: We concluded that because of staffing limitations in smaller donor organizations, and in order to better meet the needs of recipients, it would be beneficial for Canadian organizations to communicate and collaborate with one another to share resources and expertise when planning donations overseas.