Public college and university foundations are undergoing a significant transition that could change their relationships with the boards and presidents of the institutions with which they are affiliated. Such foundations have been around for over a century. The growth in the value of assets held by foundations, and their increasing significance to their affiliated institutions have, inevitably, fostered tensions between the presidents and boards of public institutions and their foundations' chief executives and boards. The stakes are clear when one realizes that 50 percent of the university-affiliated foundations belonging to AGB have assets of $100 million or more. In recent years, moreover, such growing pains have been complicated by a number of other factors that are affecting the role of foundations and their relationships with the institutions they support. In this article, the authors discuss these factors.