The present report has been prepared in response to General Assembly resolution 67/147. Obstetric fistula is a devastating childbirth injury that leaves women incontinent and often stigmatized and isolated from their families and communities. It is a stark outcome of 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 by countries at the global, regional and national levels, and by the United Nations system, to end obstetric fistula. It offers recommendations to intensify these efforts, within a human rights-based approach, to end obstetric fistula in the days remaining for the achievement of Millennium Development Goal 5 and beyond, by improving maternal health, strengthening health systems, reducing health inequities and increasing the levels and predictability of funding.