The realisation of the MDGs has been impacted upon by some of the rules, recent proposals and developments in the World Trade Organisation (WTO). This paper shows some of the effects the multilateral organisation has had on the MDG goals and targets that government leaders have collectively wanted to achieve. It begins with a brief assessment of the problems arising from the implementation of WTO rules. This is followed by an outline of the main features and effects of some of the WTO agreements and a discussion on the decision-making system and the structural or systemic aspects of the WTO. Some suggestions for improving the situation are made for each of the topics.