We consider the adequacy of the legislative and administrative provisions for environmental and social impact assessment (ESIA) in Uganda. Environmental Impact Assessment (EIA) legislation was enacted in Uganda in 1995. Although it was intended that social impacts would also be considered, the nomenclature, organizational culture and practice of EIA has given an over-emphasis to biophysical issues, with social issues being under considered. Lack of explicit instructions about how to assess social impacts and the positioning of ESIA too late in the project cycle limit the ability of social issues to be properly considered. From document analysis, an on-line survey, in-depth interviews, reflexive practice, and a literature review, we found that there was inadequate public participation, poor follow-up, low levels of capacity in all stakeholders, and political interference in the project approval process. To improve the effectiveness of ESIA in Uganda and other developing countries, we make recommendations to address the challenges facing ESIA practice.