Integrated Child Development Services (ICDS), a centrally sponsored flagship scheme, aims at improvement in the nutritional and health status of children and pregnant women and lactating mothers in rural, tribal and urban slum areas. The programme aims to reduce the incidence of mortality, morbidity and malnutrition through delivery of a package of services like supplementary nutrition, immunisation, health check up and non-formal pre-school education (PSE). The implementation and efficacy of the scheme in West Bengal for the period from 2007-12 were subjected to Performance Audit through the test check of five districts and sampled projects and Anganwadi Centres (AWs) there under. Noticeable progress was observed towards universalisation of the programme during 2007-12. There was reduction in Infant Mortality Rate from that in 2006. However, much remains to be done as regards reduction in malnutrition among pregnant women and percentage of infants with low birth weights. The State lagged behind the achievables in case of Neonatal Mortality Rate (NMR) and Maternal Mortality Ratio (MMR). Test check disclosed many areas of concern as regards operationalising AWs, implementation of supplementary nutrition programme (SNP), availability of basic amenities in AW centres, manpower management, etc. The Department did not operationalise all projects and AWs sanctioned by GoI which deprived beneficiaries of better access to services. There was considerable delay in operationalisation of projects and AWs. Bifurcation of projects to strengthen supervision did not serve its purpose as the newly created projects were not provided with supervisory manpower. AW centres were found lacking in basic amenities, as only 25 per cent had own buildings, while 14 per cent operated in open spaces. Drinking water and toilet facilities were available in 57 and 32 per cent of AWs respectively. Forty nine (49) AWs (25 per cent) out of 200 test checked provided Supplementary Nutrition (SN) for stipulated 300 days. Further, quantum of per day per head food stuff had been reduced by the Department to cushion the price rise. At the same time, avoidable extra expenditure of 240.66 crore was incurred owing to non-availing of the GoI’s offer of supply rice at BPL rate and non-lifting of BPL rice allotted by GoI, which indicated indifference of the Department. The objective of prevention of critical diseases was not addressed adequately, shortfalls being noticed in implementation of immunisation programmes (except for tuberculosis). Non-maintenance of referral cards at AW level and lack of coordination with functionaries of Health Department resulted in serious cases of malnutrition or illness not being properly followed up. Significant shortages between 53 and 69 per cent were noticed in key supervisory posts, resulting in almost half of the AWs either not being or being inadequately supervised. As regards number of days of field visits, actual achievement was 38 per cent of normative requirement in the test checked projects during 2007-12.