The Zika virus has been confirmed in Pakistan for the first time, with researchers from the Aga Khan University (AKU) reporting laboratory evidence that the Zika virus is present and circulating in the country. Alarmed by the unusual pattern, AKU's infectious diseases team, working with global collaborators, performed advanced molecular testing and metagenomic sequencing on blood samples from symptomatic patients. The results confirmed the co-circulation of dengue virus serotype 2 and Zika virus in Karachi, including cases where patients were infected with both viruses simultaneously. In Pakistan, where dengue and chikungunya, two mosquito-borne viruses, are already entrenched, the emergence of Zika adds a new layer of complexity to vector-borne disease control. Without routine screening, health workers may continue to misdiagnose Zika as dengue, leading to missed opportunities for intervention, especially in pregnancies.