Parts of Gilgit-Baltistan (GB), the northeastern most administrative region of Pakistan, have been undergoing a dramatic transformation over the last three decades. Given the challenging environment, GB's development outcomes are impressive, built on the time-tempered resilience of the people of GB and facilitated by high levels of social capital. GB has also benefitted from the attentions of the national Government of Pakistan (GoP) (motivated in no small measure by geopolitical and national cohesion considerations) and the strong engagement of civil society organizations (CSOs). The structure of the report follows the storyline of seeking to overcome the odds and broaden the transformation, with a review of development performance to date, a discussion of the main challenges the GB faces, a set of discussions at the sectoral level (based on a series of background papers that are available separately and listed in annex two), and an appraisal of what it will take to follow through on some key policy options, in terms of capacity, consultations, political will, fiscal reforms, and additional resources. The sectoral narratives are arranged in three groups: sources of private sector led growth (agriculture, minerals, tourism, and trade), key public services (social protection, education, health, and water supply and sanitation) and essential infrastructure (irrigation, electricity, and transport), all of which are critical to enhancing development performance. Meaningful steps and actions that will promote progress in each sector are identified, separated into those that appear feasible now, and those that will need to await more favorable circumstances in the future. The rest of the executive summary mirrors the structure of the main report, concluding with a table listing the top 15 policy options for immediate action and for pursuit over the medium-term (the full set of policy options is compiled in annex three).