In this article we examine the development of career guidance in Pakistani higher education. The article is based on a literature review supplemented with new data gathered from a review of higher education institutions' websites and five case study interviews. It considers both local and global influences as relevant contexts for understanding how the development of career guidance in Pakistani higher education is taking place. Concerns about alignment between skills supply and demand provide key drivers both for the development of career guidance and for a wider higher education reform. The practice of career guidance in Pakistani higher education is shown to be lagging behind policy and will need to be strengthened by new policy, resources and indigenous theories.