This paper examines broadly the intergovernmental structure in the Middle East and North Africa region, which has one of the most centralized government structures in the world. The authors address the reasons behind this centralized structure by looking first at the history behind the tax systems of the region. They review the Ottoman taxation system, which has been predominantly influential as a model, and discuss its impact on current government structure. They also discuss the current intergovernmental structure by examining the type and degree of decentralization in five countries representative of the region: Egypt, Iran, West Bank/Gaza, Tunisia, and Yemen. Cross-country regression analysis using panel data for a broader set of countries leads to better understanding of the factors behind heavy centralization in the region. The findings show that external conflicts constitute a major roadblock to decentralization in the region.