Reproductive and Child Health (RCH) is the most important programme under NRHM for improvement of Maternal and Child Health care. Considering the substantial expenditure (Rs 4,461.92 crore) incurred by the State Government of Assam under the programme during 2011-16 and with a view to assess the impact of NRHM on RCH, the Performance Audit (PA) of the programme was taken up. In the PA, efforts of the State Health Mission (SHM) on improving RCH in terms of availability of infrastructure, health care personnel, the quality of health care provided, achievement relating to Infant Mortality Rate (IMR), Maternal Mortality Rate (MMR) and Total Fertility Rate (TFR) and related health information and management system under the programme were reviewed highlighting the areas of concern which need to be addressed for achieving the intended goals. It was noticed in audit that 98.13 per cent children up to one year of age were immunised and 98.57 per cent of the target for pulse polio administration was achieved under the programme which was high but 100 per cent immunisation to eradicate Polio from the State was yet to be achieved. Increase in institutional deliveries and providing Post Natal Care facility was also seen. The percentage of Pregnant Women (PW) who received 3rd Ante Natal Care (ANC) in the 28 to 32 weeks of pregnancy increased from 71 to 87 per cent during 2012-16. The rate of still birth had also reduced simultaneously and came down from 2.55 to 2.05 per cent. There were, however, areas of concern like shortfall in infrastructure and health care professionals, 85 per cent of home deliveries remained unattended by Skilled Birth Attendant (SBA), PW/mothers had to spend their own money for conducting deliveries in government health centres against the norm of free and no expense delivery, non-achievement of target of reduction in MMR, IMR and TFR and some other related issues which would require action on the part of the NRHM, Assam on priority basis.