Introduction. Male circumcision is a recommended practice in Muslim tradition. It is important to ensure that this procedure is
performed as safely as possible in these communities. Methods. Five hundred adult men and women with at least one male child
less than 18 years were interviewed in Karachi, Pakistan, regarding details of their child’s circumcision. The survey focused on
actual and perceived delays in circumcision and perceptions about appropriate age and reasons and benefits and complications
of the procedure. Circumcisions done after two months of age were defined as delayed. Results. Religious requirement was the
primary reason for circumcision in 92.6% of children. However, 89.6% of respondents were of the opinion that circumcision
had medical benefits as well. Half of the children (54.1%) had delayed circumcision (range 2.5 months to 13 years), even though
81.2% of parents were of the opinion that circumcisions should be done within 60 days of birth. Facility-delivered babies had less
delay in circumcisions (49.1%) as compared to home-delivered babies (60.5%). Conclusion. Understanding the perceptions and
practices around male circumcision can help guide national strategies for designing and implementing safe circumcision programs
in Muslim-majority settings, with the potential to benefit an annual birth cohort of 20–25 million boys worldwide.