Watson Institute for International and Public Affairs
Costs of War

Pakistani Civilians

The United States has steadily increased its support of counter-insurgency campaigns by the government of Pakistan through direct military aid and training, and compensation for assistance to the U.S. war in Afghanistan. The U.S. has also used Pakistan as a major supply route for weapons, fuel, and material into Afghanistan, in addition to launching cross border attacks into Afghanistan from Pakistan’s territory.

This increased U.S. support has coincided with a dramatic escalation of the conflict between local Pakistani insurgents and their government. Most of the fighting is concentrated in the Northwest, near the border with Afghanistan, but the bloodshed not infrequently affects civilians throughout Pakistan. 

The U.S. began its semi-covert campaign of drone strikes in 2004 to kill Al Qaeda and Taliban forces based in Northern Pakistan. The strikes are obscured by secrecy and are of questionable legality. There is also a debate about who and how many have been killed in the strikes. According to the highest estimates, these strikes have killed thousands of people.

Approximately 66,650 Pakistanis – civilians and opposition fighters – have been killed since 2001. Of these, about 24,099 are civilians.

Key Findings

  • A major war, with U.S. support and participation, has been ongoing in Pakistan. 

  • Some suicide bombings in Pakistan are carried out in direct retaliation to U.S. drone strikes in the region.

  • U.S. drone strikes may have killed as thousands of people, most of them civilians, and have been deeply unpopular in Pakistan.


  • The U.S. government should ensure that civilian deaths and injuries are included in public reporting of war deaths and should include a tally of children killed.

(Page updated as of March 2023)