In recent years, an increasing number of major universities have set up international branch campuses (IBCs). There are now more than 200 IBCs, with more under development. Little is known about the unique challenges that face IBC managers, who are normally seconded from the home university to set up and operate the satellite campus in a new and alien environment. At the same time, there are significant financial and reputational risks for the home university should an IBC fail. This article reports the results of a qualitative study into the "lived experiences" of IBC managers working in the three largest host markets for IBCs--China, Malaysia, and the United Arab Emirates. It finds that the fundamental challenge for managers is balancing the competing demands of a range of internal and external stakeholders and concludes that universities need to do more to prepare and support IBC managers.