This report compares the demand for port services in Pakistan with the supply of facilities at Karachi and Port Qasim. It provides a comparative assessment of alternative ways of closing the gap between demand and the improvement of the capacity and access to these ports. It further explores the costs, process and impacts on a potential relocation of Karachi Port. The Demand projections and capacity assessments undertaken in the last decade have been quite frequent but are partial. The focus of these assessments has either been on one or two specific products or types of cargo, or one or two determinants of capacity. The most recent being the National Seaports Development Plan and Competitiveness Strategy by the Ministry of Communications in 2019. This report is divided into seven chapters. The first provides a summary of the current institutional framework within which Karachi’s port facilities are planned. This was necessary as the last decade unsuccessfully struggled to get institutional agreement on how to increase port capacity. The second chapter provides a summary of institutional framework under which the two ports are managed. The third chapter deals with projections of demand for port facilities. This forecasting of demand for port facilities is a complex task, exacerbated by uncertainties around world trade growth, in relation to growth in Pakistan’s economy and where within the country that growth might occur. The fourth chapter provides estimates of the realizable capacity in relation to four characteristics of Karachi ports system, any one of which could prove to be the binding constraint. The four characteristics are: (i) the maritime approach channels, (ii) the berths and terminals, storage and (iv) land-side access. Each capacity assessment takes account of facilities currently available, planned and committed. Excluded from the assessment are the planned but not committed capacity expansions, as often they fail to materialize for lack of secured funding. The fifth chapter compares demand and capacity projections together with a brief description of key actions that have been proposed for dealing with shortages capacity. The sixth chapter provides long-term strategies to address port capacity based on their comparative costs. The outcomes are recommendations for the long-term future development of Karachi’s ports. The seventh and final chapter presents capital expenditure (CAPEX) estimate and key implications of a potential relocation of the Port of Karachi.