This chapter explores distributive justice and beneficence. Justice involves giving individuals what they are due. Distributive justice governs the distribution of valuable resources and of burdens, and the granting of certain legal rights. Beneficence concerns agents’ duties to benefit other individuals. The chapter highlights distinctions (1) between the ideal and the nonideal and (2) between how institutions should be arranged and how individuals should act. We understand nonideal theory to address what particular actors – both states and persons – should do in the actual world today. Regarding institutions, domestically, we defend a liberal egalitarian view about distributive justice: unchosen differences in individual advantage within a society are prima facie unjust. Globally, we endorse cosmopolitanism: similar principles of justice apply internationally as apply domestically. Regarding individuals’ obligations, we defend moderately extensive duties of beneficence. We argue that national governments should ensure that all their residents have access to affordable health care and that the international community ought to amend the global intellectual property regime that governs pharmaceutical patents.