Social work in East Africa is confronted with myriad social and structural problems. The heritage of imported theories and concepts from the West is still affecting education and practice. The profession lacks resources and has only limited influence on social policies. Since 2010, a multi-phase, research-focused project called PROSOWO has been running in order to bring the professionalization of social work on the agenda. In this article, empirical data are discussed with regard to developmental and indigenized social work in these countries. The discussion reflects on social work in East Africa from a cross-cultural perspective.