Chikungunya virus disease (CHIKVD) is a re-evolving public health threat worldwide, including in Pakistan, since 2024 new cases of infection have been reported in the country, with spikes in infection observed in Karachi. Technically limited as well as decentralized diagnostic capacity and clinical overlap of infection with dengue contribute to underdiagnosis and delayed treatment among patients. The reappearance of the infection highlights structural gaps in the surveillance integration, laboratory infrastructure, and vector control strategies of Pakistan. Strengthening provincial diagnostic facilities, enhancing routine arboviral surveillance, integrating CHIKVD into national vector-borne disease programs, and promoting coordinated community-based mosquito control are essential for preventing endemic diseases nationwide. Without timely and effective system-level interventions, CHIKVD may accelerate from sporadic outbreaks to sustained urban transmission, posing recurrent strain on Pakistan’s healthcare system.