Pakistan, like many other South Asian developing countries, has made attempts to open up its economy since the late 1980s. The impulse for liberalisation came from the unsustainable current account deficit which was the outcome of the overvalued exchange rates and severe restrictions in trade and payment regimes. To reduce the current account deficit, assistance was sought from the IMF/World Bank, which they provided by formulating structural adjustment programmes (SAPs). It was taught that these changes will attract foreign investment, facilitate employment-intensive exports, leading to lower poverty outcomes. However, success so far in achieving higher growth and reducing poverty has not been very encouraging. The purpose of this chapter is to examine the impact of policy changes brought about by the structural adjustment programmes on growth, employment and poverty in Pakistan.