Science diplomacy, meaning the use of scientific collaboration to strengthen international relations and address shared global challenges, has long been hailed as a force for good. Yet, as Dr. Rasha Bayoumi of the University of Birmingham Dubai and her colleagues argue in their Editorial for a special issue in the journal Frontiers in Public Health, this optimism often masks uncomfortable realities. The practice of science diplomacy has too often reproduced the very inequalities it aims to dismantle, operating within frameworks that privilege powerful nations and institutions while marginalizing voices from the Global South.