Workers are increasingly seeking meaningful work - but meaning can prove elusive, while lack of meaning can lead to poor mental health outcomes. To exemplify this, we examined aid workers who are overwhelmingly motivated to undertake meaningful work. In our initial qualitative study with 218 aid workers in 63 countries, aid workers identified the stress caused by frustrated attempts to undertake meaningful work, and noted coping strategies to increase meaning such increasing contact with aid recipients. A second quantitative study with 386 aid workers found the presence of meaning predicted both increased wellbeing and decreased psychological distress over and above the effects of resilience and psychological flexibility. This indicates meaning can provide both protective and promotive effects for aid worker mental health. Meanwhile, higher levels of search for meaning predicted higher psychological distress. I will use this case study to discuss the gap between expectations of meaningful work and the reality. I also highlight the gap between what society sanctions as meaningful careers and what workers find personally meaningful. And finally, I will discuss factors to increase workplace meaning including proximity to and visibility of impact. These factors form the basis for a meaningful work intervention currently being tested.