Background:The 2019 novel coronavirus disease (COVID-19) has spread to more than 213 countries and as of 17th April 2020, 1995,983 confirmed cases and 131,037 deaths have been reported globally. Pakistan being sharing border with China and Iran, having high frequency of travel and trade has been at risk of viral transmission.Methods:We examined current state of COVID-19 epidemic and preparedness in Pakistan using publicly available data and documents on COVID-19 government dashboard.Results:Pakistan reported its first 2 confirmed cases, on 26th February 2020 linked to travel history of Iran. The number of confirmed cases nationwide rose to 7,025 on 17th April 2020 with 135 deaths and 3276 confirmed cases in Punjab,2008 cases in Sindh,993 in Khyber Pathunkhawa,303 in Baluchistan,237 in Gilgit Baltistan,154 in ICT and 46 in Azad Jammu Kashmir. To-date 7000 Pakistani pilgrims have returned from Iran and placed in quarantine in Taftan. Directing of pilgrims back to their cities without testing at the border resulted in introduction of virus in country. Pakistan’s weak healthcare system with 0.6 bed for 1000 people and less than 0.75% of GDP as health spending is doubtful to bear the COVID-19 shock in case of exponential increase in cases.Conclusion:Low literacy rate and general lack of awareness leading to non-seriousness of people towards the adoption of social distancing and hand hygiene. The high population density in major cities of Pakistan can facilitate in the spread of virus. Three-pronged approach of trace, test and treat needs to be aggressively implemented to halt the community transmission leading to exponential increase in cases. Keywords:COVID-19,Preparedness,Three-pronged approach, community transmission.