This report is prepared in response to General Assembly resolution 65/188. Obstetric fistula is a devastating childbirth injury that leaves women incontinent, often stigmatized, and isolated from their communities. It is a stark outcome of socioeconomic and gender inequalities, human rights denial and poor access to reproductive health services, including maternal and newborn care, and an indication of high levels of maternal death and disability. The report outlines efforts made at the international, regional and national levels, and by the United Nations system, to end obstetric fistula. It offers recommendations to intensify these efforts, within a humanrights-based approach, to end obstetric fistula as a key step towards achieving Millennium Development Goal 5, by improving maternal health, strengthening health systems, reducing health inequities, and increasing the levels and predictability of funding.