Higher education aid, initially, was primarily used to provide graduate training in donor countries. Later, aid money was invested to establish new institutions or to strengthen existing institutions in the developing world. With criticisms of brain drain, mounting unemployment of the educated, and the emerging priority of Education for All programs, donor support to higher education declined from the 1980s. However, higher education is back on the agenda of the donors in this millennium. The analysis in this paper shows that higher education aid either remains concentrated in selected countries with expanded higher education systems, or is fragmented and spread too thinly mostly in countries with less expanded higher education systems. The paper argues for aid to support the higher education sector in implementing national policies and institution-wide improvement rather than focusing on selected faculties for targeted intervention. This may be a way of improving aid effectiveness in higher education.