The international disaster-relief organization Doctors without Borders (MSF) is a dynamic geopolitical actor. Using a systematic literature review of academic journal articles and first person accounts by doctors from the field, the geopolitical role of MSF was analyzed. This search returned a wide range of articles many of which referenced the term “humanitarian space”. MSF utilizes humanitarian space to accomplish their medical work and witnessing actions in disaster areas. MSF’s geopolitical role stems from many of the central characteristics of the organization, but the process of creating humanitarian space engages them differently at both a global and a local level. Case studies of MSF’s work in Haiti and Rwanda reveal the interplay between global and local levels. Humanitarian space at the global level is a more imagined space. At this level, MSF relies on their practice of “témoignage” or testifying as their primary method for creating this space. At the local level, MSF focuses on their humanitarian patient-care to earn themselves space uninhibited by other power-wielding groups. These two levels work as a see-saw so that when the humanitarian space occupied by MSF is threatened at one level they can lean on their space at other in order to continue providing the best services possible. During the Rwandan genocide, MSF’s on the ground was work was limited to a single hospital in a single city and to compensate, they worked hard at the global level to bring attention to the violent situation in the country. This balance switched in the aftermath of the Haiti earthquake of 2010 during which massive space for humanitarian action on the ground, made advocating at a local level unnecessary. Analysis of MSF from a political geography perspective opens up new avenues of examining the many interdisciplinary characteristics of an organization as wide-reaching as Doctors without Borders.