The current trade war between China and the United States has drawn global attention to competition in US-China relations. Such competition should not, however, obscure areas of mutual interest where cooperation is possible. Based on US-China trilateral pilot projects, trilateral cooperation creates opportunities for aid officials and practitioners from China and the United States to communicate, but it would be ambitious to expect the limited number of pilot projects to shape Chinese aid practices or improve Chinese aid performances in the short term. These pilot projects are small in scale, and the level of coordination between China and the United States should be strengthened further. More effort by both sides is needed if trilateral aid cooperation is to sustain and even thrive. In this context, trilateral aid cooperation has the potential to become a modality in the middle, promoting mutual understanding and facilitating coordination.