This paper will evaluate and assess the effectiveness of US assistance and aid to Pakistan as an instrument of US policy in the region. At a time when the US budget is under increasing scrutiny, some questions rightly are directed at foreign aid and whether it is productive. With Pakistan being one of the largest recipients of US assistance, detailed examination is indeed warranted as to how effectively aid is carrying out US objectives. Following an introductory session, this paper focuses on US national politico-strategic objectives and US military objectives in Pakistan as compared with Pakistan objectives the record of recent US humanitarian aid and security assistance to Pakistan and a review of the effects of this aid on Pakistani opinion and recommendations for applying this aid in the future to better affect public opinion and thus more successfully achieve US objectives. Five recommendations for a more effective US aid program are presented in the report. First and foremost is the requirement for high level diplomatic engagement to better communicate US partnership and policies with Pakistan. US senior leaders should continue diplomatic efforts to strengthen the relations between the two countries in light of recent negative events. Also important at the highest level is for US diplomats to acknowledge that an India threat is Pakistans primary concern and encourage future India-Pakistan dialogue. Additionally, US diplomats should emphasize a message of co-investment when it comes to the war on terror so as not to create Pakistan dependency on US aid. Other recommendations include developing a strategic communication plan to the Pakistan public regarding US policies and aid intent, prioritizing sustainable and meaningful aid projects, ensuring accountability in the aid program, and more direct interaction with the Pakistani people.