The practice of intercountry adoption is considered from a historical framework, beginning with World War II to other conflicts and the global dynamics of child circulation for adoption. Significant sources of children are presented, including Russia, China, and Guatemala, as well as moratoriums related to poor practice and fraud. Framed from a social justice perspective, the Hague Convention on Intercountry Adoption is presented with an exploration of child sales and abduction into intercountry adoption. A global market for children creates significant practice challenges for social workers who engage in assessment, both in the country of child origin and in the destination country. Follow-up care includes case management to support families and children in the intercountry adoption process. In conclusion, the significant decline in the practice is reflected upon pragmatically; the need for true reform in the practice is necessary to preserve intercountry adoption for orphaned and vulnerable children.