Many international organisations (IOs) with overlapping governance mandates work together across a variety of issue areas. The specialist literatures on IOs, regime complexes and transnational networks are relatively silent on this particular phenomenon, instead foregrounding dynamics that either unfold within a single IO or that reach beyond IOs. This paper starts from the assumption that IOs are particularly open to influence from peers with whom they engage on a regular basis. I therefore take a meso-level perspective that pays close attention to what happens between IOs. Using examples drawn from fieldwork on interactions between the International Monetary Fund (IMF) and the World Bank, I argue that inter-IO collaboration adds a new dimension to our understanding of ‘organisational pathologies’. I delineate four specific pathologies of collaboration that relate to IOs’ ideational, epistemic, communicative and policy-making limitations: (1) failure to see, (2) failure to link, (3) failure to tell and (4) failure to fix. These inter-organisational pathologies are of interest to both rationalist and constructivist scholars because they draw attention to the difficulties of co-governance in contemporary world politics.