Infectious diseases remain major issue in healthcare settings in our country. Laboratory diagnosis of infectious disease plays an important role in management of the infections, especially nosocomial infections and infections in immune-compromised patients. To meet requirement sof advanced tertiary care hospital and transplant services at SIH, the clinical microbiology deals with bacterial culture and susceptibility, fungal culture & susceptibility, mycobacteriology, serodiagnosis, and clinical pathology. For this purpose the lab has qualified FCPS microbiologists. The technologists are also very well qualified and experienced. Two technologists are M.Phil, while most other have masters degrees. The lab is very well equipped to work smoothly and efficiently. Two units of most modern blood culture systems are working in the lab. Fully automated urinalysis system (DIRUIH-800 with FUS-200) has recently been installed, which has greatly improved quality of testing as well as turnaround time of reporting. Recently, automatic modern autoclaves, bio-safety cabinet class IIA, modern incubator, LED microscope have been acquired to do quality testing at the lab. Most labs in our region use human blood for bacterial cultures. Recently, we have made proper arrangements for sheep blood to meet full requirements of our lab. Bacteriology and Mycology has been improved by adding better identification tests like API 20NE and API 20C AUX. for susceptibility testing several MIC tests for important anti-bacterials and anti-fungals have been started to help in management of complicated and serious infections. Moreover, multipoint inoculator is used for doing susceptibility of important drugs like colistin and vancomycin. Anaerobic bacteriology has been strengthened as anaerobic cultures are now done on routine basis. We are in process of acquiring rapid fungal diagnostic tests for immunocompromised patients of bone marrow transplant and solid organ transplant. These include fungitel, galactomannan, cryptococcal antigen, and pneumocyctis immunofluorescense tests. The new TB lab has been designed keeping in view full bio-safety requirements to perform TB cultures and susceptibility. TB culture is done on state of the art BACTEC MGIT 960. Recently facility for doing second line drug susceptibility testing has been established. Molecular diagnosis of tuberculosis has now emerged as an important tool for early diagnosis. For this purpose state of the art technology of GeneXpert has recently been acquired. The lab is aligned with quality policy of the hospital and regularly participates in external quality schemes like National TB reference Laboratory (NTRL) External Quality Assessment of DST of MTB from supranational reference laboratory (SRL) Antwerp Belgium, and NEQAB for bacterial culture by AFIP Rawalpindi. The lab is in process of starting fellowship residency program to strengthen academic activities and interaction with clinicians.