The process of buying creative advertising is often as difficult for marketing clients as it is for advertising agencies. Clients are frequently risk averse in making decisions about creative work and may favor work that is less creative and effective because it is easier to accept. Advertising agencies can also display risk aversion. Fear of losing business may cause them to pander to clients, even toning down ideas that may be the most effective advertising solutions. The authors have coined the term clientelism to describe this phenomenon. Client risk aversion and agency clientelism ultimately suppress the quality of work clients adopt. We show these effects empirically by collecting data on 258 advertising campaigns produced by major London advertising agencies. Although working toward highly creative advertising is uncomfortable for clients—and this discomfort spreads to agencies—clients need to expect agencies to present their best creative work and agencies need to better assist clients in adopting these campaigns.