The article discusses the challenges faced by Syrian medical non-governmental organisations (NGOs) during the crisis. These NGOs emerged in response to various issues, including severe violence, a lack of public health services, and the need for neutral humanitarian assistance. They face challenges such as weak organizational skills, donor dependency, logistical and security issues, and maintaining neutrality. The article emphasizes the need for these NGOs to improve skills, strategically plan beyond crisis response, and initiate projects covering both sides of the conflict. The analysis also reflects on the NGOs' relationships with other Syrian medical NGOs, international donors, community-based organizations, local administration councils, military factions, and governments in neighboring countries.