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While coverage of the 2015 refugee crisis highlighted the impact on Europe, countries of the Middle East and North Africa host approximately four times the number of refugees, in addition to millions of migrants. Yet we know comparatively little about what determines host states’ policy toward newcomers in this region. Under what conditions do states offer access to residency, employment and services on par with citizens, or what drives them to treat migrants and refugees with exclusion? Because the literature on migration policy choices is drawn almost entirely from the experiences of Europe, North America and Australia, there are limited insights to offer for countries that fall outside of these regions. Furthermore, the literature on refugees builds on incorrect assumptions about migration in MENA host states, e.g., the notion of refugee impermanence, the geographic isolation of the refugee population, and, perhaps most importantly, the capacity of the receiving state itself. In this paper I ask: What determines how MENA host states choose to engage with migrants and refugees residing semi-permanently on their territories? Using original data collected between September 2014 and June 2015 in three Middle East and North African countries—Egypt, Morocco and Turkey—this paper examines host state engagement policies over the last decade in each country. Through content analysis of 133 interviews conducted with government officials, international humanitarian organizations, local NGOs and individual migrants and refugees, I find that ambivalence best characterizes host state engagement choices in these three countries; that is, we mistake the absence of formal policy for neglect. This paper explains how each state has benefited from a policy of ambivalence and which factors have led some states, namely, Morocco and Turkey, to begin moving away from ambivalence to other more proactive engagement policies.