The electricity sector in the Middle East and North Africa (MENA) is in the grip of an apparent paradox. Although the region continues to hold the world’s largest oil and gas reserves and has been able to maintain electricity access rates of close to hundred percent in most of its economies, it may not be in a position to cater to the future electricity needs of its fast-growing population and their business activities. Primary energy demand in the region is expected to continue to rise at an annual rate of 1.9 percent through 2035, requiring a significant increase in generating capacity. Investments have not been rising fast enough to meet that requirement. The report is divided into two parts and several appendices. Part I (chapters 1–5) focuses on the region. Part II (chapters 6–10) consists of four country studies and a synopsis of all four. A short conclusion evokes the main themes and lessons from the entire report. Across the report, information at the utility level drawn from the MENA Electricity Database forms the basis of the analysis. Chapter 1 calculates the QFD (or hidden costs) of the power sector in each of the fourteen MENA economies studied, a first attempt to quantify the hidden costs of power sector inefficiencies in the region. Chapter 2 provides a snapshot of key performance indicators of MENA power utilities for which international comparisons are possible. Chapter 3 examines performance indicators over time. Chapter 4 considers the relative overall performance of utilities within the MENA region when more than one indicator is considered. Chapter 5 investigates whether certain organizational differences are correlated with differences in performance. Chapters 6 to 9, focuses on detailed analysis of four countries that have taken very different approaches to the power sector namely Egypt, Jordan, Morocco, and Oman.