The final substantive chapter examines the impact of international sanctions on the North Korean political economy. On the one hand, sanctions can be said to have exacerbated the tendency whereby North Korea has become an economic appendage of the booming Chinese economy. Indeed, we examine how the strengthening of sanctions have coincided with a shift away from economic relations with its erstwhile trading partners of South Korea and Japan and towards China. In terms of their impact, we argue that sanctions until 2017 at least largely failed to exert pressure on the North Korean economy, but they have at the same time deepened the illicit nature of its external economic relations. Even less have they translated into political pressure on the North Korean regime. We also examine the impact of increased enforcement by China of UN sanctions since 2017 and the Trump administration’s “maximum pressure” campaign. By examining the unintended consequences of sanctions, the chapter contributes to critiques of the mainstream sanctions literature and has direct policy implications.