Balance of payments crises and resort to IMF borrowing is a recurrent feature of Pakistan’s economy. In the last three decades, there were few years when Pakistan was not in an IMF program. Fiscal mismanagement has played an oversized role in this, requiring prolonged periods of austerity and macroeconomic adjustment. A major objective of this book is to understand what drives the large and persistent fiscal deficits that lie at the heart of our economic malaise and how this may be addressed. Any charter for economic revival requires an agreement on prudent fiscal management among the main political parties and other power centers. To that end, this book, reviews a vast body of empirical research and policy documents to focus on three aspects of Pakistan’s fiscal deficits. Firstly, it examines the macro-economic consequences of the persistent fiscal deficits and assesses efforts to stabilize the economy under the IMF tutelage.