The implementation of economic, social and cultural rights (ESCR) has a number of interrelated dimensions. In this chapter, we outline two of them: ﬁ rst, how the ESCR provisions of human rights treaties are given effect in domestic laws and institutions, including litigation before national courts and court orders requiring the authorities to take appropriate measures to fulﬁ l their legal obligations. Although very important, this dimension of ESCR implementation is unlikely to engage most of those working in sectors such as health, food, housing, education, water and sanitation. For them, implementation has a second dimension. Take children’s health rights as an example. For a policy-maker or practitioner in children’s health, the implementation of children’s rights refers to the speciﬁ c, practical and operational interventions needed to deliver children’s access to immunisation programmes, safe drinking water, adequate nutrition, reliable health information, health care and so on. For health professionals, the implementation of children’s rights implicates the design, delivery and ﬁ nancing of clinical and public health interventions, such as practical outreach programmes, which are needed to ensure equitable access for all children, including those living in remote and impoverished communities. If human rights experts advise health professionals on the implementation of children’s health rights, and they only survey laws, litigation and court orders, they are likely to be heard with polite mystiﬁ cation. While these opening remarks have illustratively referred to health rights, the same point arises in relation to all ESCR.