Health Care Delivery System (HCDS) is the arrangement that serves best to any country’s population with effective, efficient, fair distributions of resources, and funds for organized infrastructure to thrive well. Globally, HCDS becomes a highly competitive and rapidly growing service and needs special attentions from different domains. The optimal HCDS provides hope, relief to the individual, community, and population. The balanced health care system delivers the quality of care, health, and facilities through efficient, effective, and fair manner. Moreover, across the world the HCDS varies from country to country and focusing on improving access, coverage and quality of services, however, it depends on the key resources being available, organized, managed, and utilized effectively. In this paper, we will discuss HCDS of Pakistan in comparison to Bangladesh with areas of governance, service delivery, finance, information, human resources, and medical technologies and will analyze HCDS of both countries, and ends with challenges, recommendations to improve health care reforms and its utilization.