Sindh has the potential to become a highmiddle-income province in Pakistan, but it lags far behindin terms of economic, social and development indicators.Sindh is also the most industrialized province,resource-rich and endowed with the country’s largest naturalgas and coal reserves. In sum, it has the potential tobecome a high-growth and high-income region. Nonetheless,Sindh has yet to translate this potential into commensurateeconomic and social development. The province faces majordevelopmental challenges. Sindh’s weak social indicators arepartly the result of the inadequate reach and low quality ofpublic service delivery. This Public Expenditure Reviewfocuses on provincial finances and their utilization withthe objective of identifying possible reforms to expand theresource envelope and ensure better value for money byimproving the management and efficiency of public spending.It includes two important components: (i) a detailedanalysis of the major revenue challenges and the variousexpenditures, including development spending and; (ii) andin-depth assessment of how some of the key governmentpriorities are undertaken, such as education, health, andsocial protection. The hope is that by better understandingthe constraints, reforms can be designed and implemented tomaximize Sindh’s potential and promote a more equitable andproductive path.