Discerning the likely direction of events in the Middle East and their impact on the Palestinian refugees is a speculative but important step in trying to avoid pitfalls and policy errors of the past. The challenge is particularly difficult at this moment of great change: a financial crisis of systemic proportions, the rise of China and India as global actors, the accelerating impact of climate change, and the start of the Obama presidency in the United States. This contribution briefly examines the current situation of Palestinian refugees before presenting an overview of wider trends in the world refugee populations under United Nations High Commissioner for Refugees (UNHCR) jurisdiction with a particular focus on repatriation flows, resettlement, and local integration. It then focuses on possible scenarios in the resolution of the Middle East conflict, encompassing the continuation of the status quo of Israeli domination, the debate on bi-nationalism, and the two-state model for a peaceful solution. It concludes by examining these possible scenarios and applying them to specific options and programmes for the refugees and by arguing that demographic growth, the continuing preference of the international community for repatriation as a preferred option for refugees, and the results of climate change are the issues that will have the most significant impact on the future of the Palestinian refugees.