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Background and aims Use of zinc (Zn) fertilisers may be cost-effective in increasing crop yields and in alleviating dietary Zn deficiency. However, Zn fertilisers are underutilised in many countries despite the widespread occurrence of Zn-deficient soils. Here, increased Zn fertiliser-use scenarios were simulated for wheat production in Punjab and Sindh Provinces, Pakistan. Inputs and outputs were valued in terms of both potential yield gains as well as health gains in the population. Methods The current dietary Zn deficiency risk of 23.9% in Pakistan was based on food supply and wheat grain surveys.“Disability-adjusted life years (DALYs) lost” are a common metric of disease burden; an estimated 245,000 DALYs y− 1 are lost in Punjab and Sindh due to Zn deficiency. Baseline Zn fertiliser-use of 7.3 kt y− 1 ZnSO 4. H2O was obtained from published and industry sources. The wheat area currently receiving Zn …