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Food fortification is safe and cost-effective in the prevention of micronutrient deficiencies and has been widely practiced in developed countries for well over a century. Commissioned by the UK Department for International Development (DFID) Pakistan, the scoping study attached here was undertaken by an international team of consultants to investigate and compare options for food fortification initiatives in Pakistan. The study focused on three areas: the regulatory environment for food fortification, the private sector role, and potential agricultural solutions. The findings in this report clearly support the utilization of food fortification strategies at scale, which could build on the recent success of the iodized salt programme. Given the widespread prevalence in Pakistan of deficiencies in iron and in vitamins A and D, food fortification strategies offer a tangible option for delivering these micronutrients on a large scale. Zinc deficiency is also highly prevalent in Pakistan, but for zinc, agriculture options are a more feasible strategy than alternative supplementation options, but these still require further evaluative work. However, overall success would also require closer attention to strategies for improving infant and young child feeding as well as quality of complementary foods for young children.