Introduction: Abstract Nearly 12 million Pakistanis are infected with either Hepatitis B or C virus. Injection overuse and syringes reuse likely drive the high Hepatitis B and C prevalence in Pakistani communities. Ongoing national discussions have focused on increasing syringe supply to curtail syringe reuse. We measured injection need from nationally validated sources and compared with syringe supply to determine the extent of shortfall in syringes. Methods: Using Injections received data from the Pakistan Demographic Health Survey 2006-7 (N: 5429) and the National Hepatitis Survey (N: 47,043), we estimated the number of injections received in Pakistan. We matched these against the local syringe production figures from Syringe Manufacturers’ Association and importation figures from the Central Board of Revenue. Results: Approximately 711-774 million injections (4.3-4.6 injections per head) are received annually in Pakistan and around 871-916 million syringes are supplied to open markets. Overall, 52-77% Pakistanis receive at least one injection in any given year. Conclusions: Injection need in Pakistan is among the highest worldwide but is completely matched by available syringe supplies, suggesting lower reuse than previously considered. However, highly prevalent HBV and HCV suggest that even this reuse is a major public health concern and measures directed at both providers and recipients of injections are needed to curtail high injection need and syringe reuse are needed.