Imran Khan, after securing 176 votes, became the 22nd Prime Minister of Pakistan on August 18, 2018, overseeing significant reshuffles in key government positions. His cabinet choices included many former ministers from the Musharraf era, with some defections from the left-wing People's Party. Internationally, Khan maintained a delicate balance in foreign relations, especially with Saudi Arabia and Iran, while prioritizing ties with China. He faced criticism for his remarks on sensitive issues, including those related to Osama bin Laden and women's attire.

In terms of economic policy, Khan's government sought an IMF bailout to address the balance of payments and debt crisis, leading to austerity measures and a focus on tax revenue increase and import tariffs. These measures, along with high remittances, improved Pakistan's fiscal position. Khan's administration also made notable progress in improving Pakistan's ease of doing business ranking and renegotiated the China–Pakistan Free Trade Agreement.

In security and terrorism, the government banned organizations like Jamaat-ud-Dawa and focused on addressing extremism and violence. Khan's comments on sensitive topics sometimes led to domestic and international criticism.

Socially, the government made efforts to restore religious sites of minorities and instituted reforms in education and healthcare. Khan's administration expanded Pakistan's social safety net and welfare system, though some of Khan's comments on social issues were controversial.

Environmentally, the focus was on increasing renewable energy production and halting future coal power projects. Initiatives like the Plant for Pakistan project aimed at large-scale tree plantation and expanding national parks.

In governance and anti-corruption, Khan's government worked on reforming the bloated public sector and launched a vigorous anti-corruption campaign, which recovered significant amounts but faced criticism for allegedly targeting political opponents.