This dissertation explores the domestic consequences of International Monetary Fund (IMF) program lending. It argues that when governments implement austerity reforms attached to IMF loans it increases human rights violations and violence in borrower governments. A new measure of IMF compliance is developed and used to explore the consequences of IMF lending in the 21st century. Past research exploring IMF lending consequences has assumed compliance away. While IMF program lending is largely seen as a failure there is significant debate about the causes of failure. Human rights scholars have argued that austerity policies impose significant hardships on citizens in borrower governments. International organization scholars and political economists have pointed to low compliance with reforms as a cause of negative outcomes. While both of these literatures use compliance as the causal mechanism neither directly tests whether reforms are being met. Compliance with IMF austerity is measured for all 93 IMF borrowers between 2002 and 2015. Empirical models are used to test whether IMF compliance leads to: increased government violations of collective labor rights, increased violent anti-government protests, and increased repression of physical integrity rights. I find that as compliance with IMF austerity increases labor rights respect declines, violent protests increase, and repression increases. While compliance on average is low, the findings here suggest that if governments implemented all of the reforms that the IMF asks for, global labor rights violation, domestic violence, and repression would significantly increase across the globe.