Philanthropy can drastically accelerate biomedical research. However, philanthropic dollars may do more harm than good, especially if funders fail to be mindful of sustainability, consider the current scale of available funding, or address specific barriers in the field. Under-resourced fields require significant coordination and partnerships to build an intentional funding strategy, infrastructure, and human capital necessary to grow the field and make discoveries. Philanthropic capital has the flexibility and tenacity to uncover and address the specific needs of research communities and the patience to deploy resources sustainably over time. Building trust, fostering community, and grasping the structural and scientific nuances in underfunded fields can both facilitate a monumental shift in the short-term while laying the groundwork for a lasting and outsized impact.