Public–private partnerships are often promoted as innovative solutions to infrastructure gaps and service delivery deficits in developing countries. However, in Pakistan, Public- Private Partnerships (PPPs) have evolved under bureaucratic legacies and donor-driven frameworks that often reinforce rather than resolve equity and accountability challenges. This chapter critically examines the institutional model of PPPs in Pakistan through the lens of historical institutionalism, which is a variant of the neo-institutionalism tradition. The chapter utilises 34 semistructured interviews across the public, private, civil society, and academia stakeholders. The chapter reveals that Pakistan’s PPP frequently functions as public–public arrangements in disguise, where state-run bureaucratic entities act as private partners while subverting competition, transparency, and the public interest. The chapter uses case studies of independent power producers and infrastructure megaprojects, and the analysis uncovers how PPPs in Pakistan often operate as tools of fiscal evasion, elite capture, and political optics, while marginalising citizen engagement and democratic oversight. The chapter evaluates this practice against United Nations Development Programme (UNDP’s) good governance principles and assesses the misalignment between PPPs and SDGs 9, 10, and 16. The chapter argues for a fundamental reframing of PPPs, not merely as procurement tools but as governance mechanisms that must be rooted in equity, procedural justice, and institutional accountability. Recommendations are provided for regulatory reform, inclusion mechanisms, and fiscal transparency to realign PPP practice with democratic and developmental goals.