Poverty reduction rarely progresses in countries affected by conflict and forced displacement. Mechanisms to target social assistance to reach the poorest households in such settings are therefore badly needed. This paper explores patterns of social assistance targeting using unique household survey data covering people inside and outside displaced person camps in the Central African Republic. The findings show that assistance is categorically targeted and not directed to those most in need. Internally displaced persons in camps are significantly more likely to receive social assistance than people living outside camps—including out-of-camp internally displaced persons—regardless of their level of monetary consumption. Meanwhile, people with lower monetary consumption are no likelier to receive social assistance than those with higher consumption levels. As a result, internally displaced persons in camps who are in the top consumption quintile are more than twice as likely to receive social assistance as those outside camps in the bottom consumption quintile. This means that some extremely vulnerable households are excluded from assistance. Moreover, these patterns could create perverse incentives to enter and remain in camps, especially as it emerges that those who have been in camps longer are more likely to receive social assistance. Simulations reveal that targeting social assistance based on monetary welfare could protect the most vulnerable better by reducing the depth and severity of poverty. The results underline the need to find practicable mechanisms to reach the poorest people in conflict-affected settings, both inside and outside camps.