A large proportion of people in developing countries live in rural or remote locations where grid electricity is presently unavailable and is not envisaged in the foreseeable future. Since conventional, electrically powered vapour compression refrigeration systems may not be of much use in such areas, for essential applications such as food and drug preservation, alternative refrigeration systems are required. Such systems are presented and discussed in this paper. These include photovoltaic (PV) powered vapour compression systems; continuous and intermittent liquid or solid absorption systems; and adsorption systems. Typical application examples are drawn from recent experiences worldwide. Technical and financial constraints which limit their widespread application are reviewed, and strategies for overcoming them are discussed.