The study analyzes Pakistan-United States relations, which are a combination of confrontation and cooperation. Since independence, the relations between the two States have seen many ups and downs. The purpose of this research is not only to provide an exhaustive historical account of the relations; it also aims at interpreting cooperation and confrontation between the two countries in the broader sense during Musharraf era. The research has focused on how the two countries reached various formal agreements, how the official dialogues were conducted on major issues of bilateral interest, and what impacts it had on the relationship between the two nations. It has also been enquired how the United States policy towards Pakistan changed from confrontation to cooperation after 9/11 attacks. It has also encompassed the economic dependence of Pakistan on the US aid, its social sector’s developments and the need for the US military aid for the balance of power in the region and Pakistan’s national security. The consequences and backlash on Pakistan economy, socio-religious life, and overview of the country’s law and order situation, suggestions to reduce the atmosphere of mistrust and way forward to improve the Pakistan-US relationship between the two independent-sovereign states has also been part of the analysis of the relations. This study includes details regarding the cooperation between the two countries, eradicating terrorism, improving socio-political situation in Afghanistan, removing major irritants between the two countries. Moreover, it considers Pakistan’s response to the situation in Afghanistan, steps taken by Pakistan and the US to resolve the crisis and the consequences, for Pakistan, for becoming an ally of the United States in the war on terrorism. Furthermore, it has also discussed why Pakistan’s decision to provide logistic and intelligence assistance to the US in the war on terrorism was a precautionary measure against being labelled as a terrorist state and an ally of the Taliban by the US. The research has endeavored to carry out an in depth study of Pakistan-US relations and their impact on the policies of both countries. It has also studied the issues relating to some irritants and confrontation between the two countries.