In response to requests for assistance from a Tibetan refugee community in Mainpat, India, Northern Arizona University developed a unique service-learning experience, the Mainpat Project, to provide health and other services. The project continued for 4 years despite the limited infrastructure and resources of a small public university and the complexities of working with a host community in a remote area. The Mainpat Project brought together community leaders and multidisciplinary teams of students, faculty, and staff. Based on various types of assessments, observations, and direction from the community, activities focused on needs identified by the Tibetan refugees and interventions to enhance their quality of life. This reflective essay presents results of an exploratory study of community needs, community-university interactions, interventions built on new understandings, challenges, intended and unintended outcomes, and lessons learned from this experience. Proposed strategies for future work in Mainpat build upon existing models of global service-learning.