Despite the abundant scientific evidence demonstrating the benefits of family-based care for children and the damages brought on by institution-based care, the social work profession continues to endorse and engage in practices that promote the latter. This is particularly true through orphan tourism and orphan volunteerism—short- and longer-term forms of providing aid to residential facilities caring for children. Using educational tours to orphanages, fundraising and service projects, and academic internships based in such facilities, the profession contributes to the perpetuation of institution-based care and forms of exploitation. Based on an exhaustive review of the global literature and utilising an innovative theoretical framework of ‘altruistic exploitation’, the authors explore the ironic juxtaposition of benefits and harms associated with orphan tourism to the various stakeholders. Volunteers are often exploited in fulfilling their altruistic motives while at the same time engaging in potential exploitation of the very children they aim to serve. Authors further examine social work implications in the policy, practice and research arenas, and provide examples and recommendations in preventing family separation, promoting family-based alternative care and empowering communities.