Since the Chinese government first began allowing international adoption in 1992, over 130,000 children have migrated to a wide range of countries in the global North. Although most scholarly attention has focused on healthy female adoptees, in recent years a growing number of special needs children have been placed in foreign homes. This article highlights the efforts that take place in China to transform unwanted disabled and ill children into internationally desirable daughters and sons. I draw upon extensive ethnographic fieldwork in four medical foster homes in China run by Western evangelical Christians that cared for special needs youth. In these homes, intimate reproductive and emotional labor practices that were inspired by first-world understandings of care “revalued” marginalized children and prepared them for middle-class lives abroad. The global humanitarian aid industry's presence in China has allowed government authorities to outsource intimate labor to highly resourced foreign groups that are motivated by their own child-saving agendas. This case study illustrates the ethical and material complexities that link commodified processes of global capitalism with the transnational circulation of children.