This report aims to provide technical assistance to the Government of Lithuania in preparation for the June 2009 budget amendment and beyond. This Public Expenditure Review (PER) includes a number of recommendations on short run fiscal consolidation (mainly through spending cuts) as well as efficiency-enhancing reforms that could eventually generate fiscal savings and reduce the fiscal deficit over the medium term. In the context of increased social needs arising from the crisis, this report also tries to identify the changes needed in social assistance benefits to better protect the poor and vulnerable during the crisis and beyond in a cost-efficient way. In agreement with the Government, social sectors (social protection, health, and education) have been chosen as the focus of analysis, given the room for short and medium term adjustments and the large implications of those on the overall budget. The PER also analyses the public wage bill and public administration. Finally, macroeconomic risks as well as the overall fiscal scenario and risks (including an exploration of revenue measures that could bring fiscal savings over 2009-10) are also analyzed to provide the context for the subsequent sectoral sections.