Background Attention is increasingly shifting towards the role of daily stressors in explaining mental health outcomes in humanitarian emergencies. Aims To assess the role of current perceived needs in explaining the association between past traumatic exposure and distress in humanitarian settings. Method A series of mediator analyses were conducted, using data from Jordan (displaced Iraqi people) and Nepal (Bhutanese refugees). The General Health Questionnaire (GHQ-12), the newly developed Humanitarian Emergency Settings Perceived Needs Scale (HESPER) and the traumatic events list of the Composite International Diagnostic Interview (CIDI) were used as measures of distress, current perceived needs and past traumatic events respectively. Results Current perceived needs were found to mediate the association between past traumatic exposure and distress in Jordan and, less strongly, in Nepal. Conclusions An integrated approach that includes a focus on daily stressors should be adopted to mitigate the impact of traumatic exposure in humanitarian settings.