The restructuring of governments in the countries of Central and Eastern Europe and the former Soviet Union has not led to the emergence of uniform cabinet structures across the region. The paper addresses the issue of a persistent variation in cabinet ministerial organization and size across countries and over time. It advances a patronage-based theory of cabinet formation. The central claim is that the extent of clientelistic structuring of the party system, the parliamentary/semi-presidential constitutional divide, and the character of a governing coalition have a systematic effect on politicians’ willingness to proliferate cabinet ministerial positions or to maintain already oversized cabinets. To support this claim the paper specifies and tests a number of hypotheses about the effects of political, institutional, and structural variables on the evolution of cabinet organization in the region. The evidence suggests that constitutional design and party system clientelism have a significant impact on changes in cabinet organization and size.