In 2022, severe monsoons affected over 33 million people in Pakistan, leaving 20.6 million (including 9.6 million children) in need of humanitarian assistance. Also in 2022, heavy rainfall in the southwest of the country led to flash floods, fatalities, and infrastructure damage, compounding vulnerabilities. In this case study we explore how multiple micronutrient supplements (MMS) programming has been included as part of antenatal care services in the country. We summarise the existing policies and programmes related to MMS; describe the main organisations involved in MMS programming; and highlight the main points regarding how MMS programming is planned for, delivered and monitored.  We then summarise the key opportunities and challenges for MMS programming at scale in Pakistan, organised by WHO health system building block.