An external refugee dilemma is one of the most serious North Korean humanitarian problems together with long-standing food crisis and gross human rights violations. Since the mid-1990s, hunger-stricken North Koreans have tried to escape from their country, mostly to China, but political barriers and tight border control have made the process dangerous and often unsuccessful. Even after a successful escape, those in China or countries other than South Korea are currently trapped by political, diplomatic, and legal constraints. According to the UN refugee laws, only those who leave their home countries for political reasons such as wars and persecution are entitled to seek refugee status. Deplorably, North Korean defectors in search of food, money and medicine do not meet this requirement. This legal trap has been a justification to China and other countries that are reluctant to grant the defectors protection and shelters. The Chinese government has labeled all North Korean escapees as illegal immigrants. Unless a dramatic incident such as “planned defection” happens to catch the world media, the defectors are destined to forcibly repatriation to North Korea. Once returned, they are subject to imprisonment, harsh torture, or even death penalty. Those who remained in China also face double sufferings of fugitive life and human rights abuse such as labor exploitation, human trafficking and purchasing marriage. As China has increased their surveillance and search activities, many North Koreans in China have attempted to escape to Southeast Asian countries. North Korean refugee problem needs to be addressed from the perspectives of human rights and humanitarian issues, and yet the countries involved tend to deal with the problem in terms of their political, diplomatic priorities and national interests. Although the US, Japan, Russia and other Southeast Asian countries, as well as successive Korean governments, tend to provide North Korean defectors with assistance and have not forcibly repatriate them, more comprehensive and consistent North Korean refugee policies are required to effectively address the problem. It is particularly important considering the likelihood of the North Korean contingency and related mass defection of North Korean people. While the contingency, whether it will be caused by the fall down of Kim Jong-il’s regime, the transformation of the dictatorial communist system, or the state collapse of Democratic People’s Republic of Korea, can precipitate the mass refugee problem, the North Korean regime’s loss of power and control over its citizen lapse can be caused by the large-scale refugee flow in combination with the uprising of the discontented North Korean people. No matter which scenario is more plausible, if the contingency and/or mass defection happen, the consequences will be astounding. Therefore, close policy coordination at the global and regional levels are crucial to prepare for detailed and systematic plans to address the problem.