The needs of the global South are proving to be far more complex and challenging to ameliorate than anticipated when the World Trade Organization was established amid promises of enhancing social welfare. In particular, inequality among member states has persisted despite the optimistic projections made during the Uruguay Round negotiations. This issue concerns intellectual property scholars because economic theory suggests that technology policy is a key contributor. After discussing the roles that innovation and international intellectual property protection play within the theory of economic inequality, this chapter focuses on the impact of international patent law. It demonstrates how the demands of the North for ever-stronger patent and patent-like protection exacerbate the problem of technological inequality. The chapter ends with suggestions for ways in which the patent system could be restructured to better enable local inventors to avail themselves of the global knowledge base and enhance the incentives available to innovators who fulfill the needs of the South. In the authors’ view, reducing intellectual property-based inequality in the ways this chapter outlines is a key step toward mitigating the problem of income inequality.