Latin American countries have pioneered innovations in social protection, but their welfare institutions suffer from large and persistent gaps and inequalities in access and provision. This article reviews the substantive body of research addressing this anomaly. A focus on social protection offers a window on what is distinctive about social policy in the region. The social protection matrix in Latin America combines three core institutions: occupational insurance funds, personal pensions and social assistance. The article highlights the role of political realignments shaping current institutions. The critical review yields several pointers for a ‘general’ theory of welfare institutions.