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In the United States, the dominant narrative about the use of drones in Pakistan is of a surgically precise and effective tool that makes the US safer by enabling "targeted killing" of terrorists, with minimal downsides or collateral impacts.

This narrative is false.

Following nine months of intensive research—including two investigations in Pakistan, more than 130 interviews with victims, witnesses, and experts, and review of thousands of pages of documentation and media reporting—this report presents evidence of the damaging and counterproductive effects of current US drone strike policies. Based on extensive interviews with Pakistanis living in the regions directly affected, as well as humanitarian and medical workers, this report provides new and firsthand testimony about the negative impacts US policies are having on the civilians living under drones.

Real threats to US security and to Pakistani civilians exist in the Pakistani border areas now targeted by drones. It is crucial that the US be able to protect itself from terrorist threats, and that the great harm caused by terrorists to Pakistani civilians be addressed. However, in light of significant evidence of harmful impacts to Pakistani civilians and to US interests, current policies to address terrorism through targeted killings and drone strikes must be carefully re-evaluated.

It is essential that public debate about US policies take the negative effects of current policies into account.

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