This article presents a comprehensive review of research and theory on reactions to help, organized in terms of four conceptual orientations (i.e., equity, attribution, reactance, and threat to self-esteem). For each orientation, the basic assumptions and predictions are discussed, supportive and nonsupportive data are reviewed, and an overall appraisal is offered. Threat to self-esteem is proposed as an organizing construct for research on reactions to help, and a model based on this construct is presented. It is argued that a formalized threat-to-self-esteem model is more comprehensive and parsimonious for predicting reactions to help than are equity, attribution, or reactance models.