The Lady Health Worker (LHW) Programme began in 1994 to reduce poverty and improve health. With 110,000 LHWs across the country, Pakistan has one of the largest cadres of community health workers in the world. Each LHW has a catchment area of about 1,000 people and is responsible for providing education on reproductive health and nutrition, distributing family planning, immunizing children, and encouraging women to seek ANC–but LHWs do not provide ANC themselves. LHWs have built strong relationships with traditional birth attendants and midwives to ensure pregnant women and mothers receive adequate care. Women who are served by LHWs are more likely to use contraception and to receive early PNC. The program has also contributed to a reduction in maternal and infant mortality in recent years. In order to sustain LHWs and their impact, future attention should focus on ensuring manageable caseloads and adequately integrating LHWs with primary care facilities.