Since the tribunal was set up in 1993 in the middle of the ethnic war in Bosnia, it has been attacked for going after small fry and avoiding leaders.
Mr Milosevic put himself beyond the court's reach in 1995 when he starred in securing Serb assent to the US-backed peace deal for Bosnia hammered out at Dayton, Ohio. As he shook hands and quaffed whisky with Western negotiators, Mr Milosevic the "Balkan butcher" was forgotten, and Mr Milosevic the Balkan statesman was reborn.
Since his forces unleashed the latest wave of terror on the ethnic Albanians of Kosovo, however, the outside pressures on the Hague court to leave him alone have receded.
But whether the indictment results in Mr Milosevic ever appearing the dock in the Netherland is still doubtful.
The precedents are not good. The Bosnian Serb leader, Radovan Karadzic, and his military chief, Ratko Mladic, were both indicted for war crimes during the 1992-95 siege of Sarajevo and other crimes in the Bosnian war, such as the mass execution of at least 6,000 men in the eastern town of Srebrenica in July 1995.
But although Mr Karadzic had to step down as Bosnian Serb President, he has not been arrested. Over 30,000 Western peace-keepers based in Bosnia have passed up many opportunities to seize him, even though his familiar helmet of grey hair makes him easy to spot. The troops feared an arrest might end in a bloody shoot-out with his guards and complicate their mission. The worst that Mr Karadzic has suffered is a life of enforced obscurity and the need to travel with a posse of armed lackeys.
Ms Arbour has expressed her own frustration with the refusal of the Security Council to take action against Serbia to force it to hand over earlier indicted war crime suspects.
In May she complained that 32 named suspects were still at liberty in Serbia or Serb-ruled Bosnia and bemoaned the fact that known killers such as the Serb war lord Zeljko Raznjatovic, "Arkan", had simply laughed off their indictments.
"If the Tribunal had received the assistance it requires to discharge its mandate, it is possible that the scenes we witnessed in Croatia and Bosnia ... would not now be repeated in Kosovo," she said.
The court's record is improving. From 1993 to 1997 little was done but since then the pace of arrests has quickened. Croatia and Bosnia have handed over their suspects and "snatch squads" have made several arrests in the Serb part of Bosnia.