This performance audit of National Rural Health Mission in Rajasthan for the Period 2011-2016 revealed that the Department of Medical, Health and Family Welfare did not follow"bottom up approach. Baseline survey comprising of Household Survey and Annual Facility Survey was not conducted in the State during 2011-16. Annual State Programme Implementation Plans were submitted with delays and consequently approval of GoI were also delayed. Health centres were constructed at inaccessible and uninhabited locations and contracts for construction of buildings were awarded to the contractors without ensuring the availability of land. Less number of health centres were provided in the tribal areas as compared to non-tribal areas. Rural Health Centres (Community Health Centres (CHCs), Primary Health Centres (PHCs) and Sub Centres (SCs)) were having more shortages of essential equipment as compared to District Hospitals. Further, equipment were lying unutilised due non-availability of trained staff. There were shortages in the availability of essential drugs particularly at CHCs and PHCs. There was a 62.93 per cent shortage of manpower in health centres located in rural areas. Only 64.73 and 58.45 per cent persons were appointed on contractual basis during 2014-16 respectively. There was shortage of 12.73 per cent in selection of Accredited Social Health Activists (ASHAs) and only 42.90 per cent of ASHAs could be imparted induction training in the State. The percentage of women registered in first trimester of the pregnancy, though increased from 46.59 per cent to 60 per cent during 2011-16, yet 26.93 per cent to 31.02 per cent pregnant women did not get all three mandatory checkups. Only 67.77 per cent pregnant women were given Iron Folic Acid tablets. There was no significant variation in institutional deliveries in the State during 2011-16.There was significant shortfall in Measles, Oral Polio Vaccine booster, Diphtheria, Pertussis and Tetanus booster and Tetanus Toxoid 10/16 immunisation. Involvement of men in the family planning process continued to be abysmally low. State Health Society utilised 75.11 per cent fund during 2011-16. Instances of delay in release of proportionate share by the State Government, diversion of funds, huge unadjusted advances were noticed. State Health Mission did not hold any meeting during 2011-16 and only two meetings of Governing Body were conducted. The State continues to lag behind the All India Average and stood at 23rd position (out of 28) in Infant Mortality Ratio, 25th position (out of 28) in Maternal Mortality Ratio and 17th (out of 20) in Total Fertility Rate.