This report is mainly a review of the status of family planning and the efforts to promote contraceptive use through the Population Program, and the supporting roles of other sectors and players. It is divided into three sections: the first on how the program has evolved since its inception; the second on the trends in family planning outcomes over the last two decades; and the third on explanations for Pakistan’s poor performance, and recommendations on how to make the population program more effective. Both analysis of secondary data, mainly taken from fertility surveys conducted over the last two decades, as well as primary data collection, through interviews with key stakeholders, inform the discussion in this paper. When we had almost finished writing this report, the 18 th Amendment to Pakistan’s constitution was passed by the parliament. As a result, the Ministry of Population Welfare was dissolved on December 1 st , 2010 and by March next year the Ministry of Health will also cease to exist. Although the implementation of the family planning program was already primarily done at the provincial level, the abolition of MoPW will severely impact program funding in the coming years. While we have tried to include the effects of this amendment in our report, much of the discussion is based on the situation before it.