This paper aims to extract lessons from development partners’ engagement in Myanmar to offer suggestions for improved subnational governance and balanced regional development. The analysis is based on literature that evaluates regional development interventions in Myanmar by the Japan International Cooperation Agency. These interventions were all in fields of critical importance to Myanmar’s sustainable growth—agriculture and rural development, health, and infrastructure. The lessons summarized in this paper imply that decentralization needs to be carefully designed to strike the right balance between local preferences and national/sector policy for regional development. The author recommends: 1) developing a mechanism for integrating ‘top-down’ and ‘bottom-up’ priorities, 2) deepening the process of centralizing information in order to continuously adjust strategic plans to match the needs evolving on the ground, and 3) making the best use of existing institutions at all levels of the government.