This chapter examines the development and evolution of Pakistani nuclear doctrine since the May 1998 nuclear tests. It identifies the dilemmas and challenges of Islamabad in crafting a suitable use doctrine. The nuclear doctrine of a state specifies its formal and informal plans for the use of nuclear weapons to achieve intended political, military or other objectives. To build the intended deterrent and institutionalise nuclear decision-making, Islamabad announced the setting up of a National Command Authority (NCA) on 2 February 2000. Besides the setting up of the NCA, Islamabad has hardly announced anything substantive about its minimum nuclear deterrence posture or nuclear use doctrine. Pakistan's strategic analysts also support their country's adoption of a nuclear first-use principle and Islamabad's rejection of India's offer for an NFU agreement, and echo arguments. The India factor and the preferences of the military will remain as the key factors in shaping the evolution of the country's nuclear doctrine.