At least 372 Afghan civilians have been killed and 397 wounded in cross-border fighting between Taliban forces and the Pakistani military in the first three months of 2026, according to a report by the United Nations Assistance Mission in Afghanistan (UNAMA). The toll is the highest recorded by UNAMA for the same period since 2011 and includes 13 women, 46 children (31 boys, 16 girls), and 313 men, based on data from three independent sources verified by the mission.
Cross-border clashes between Afghanistan and Pakistan have escalated sharply since the Taliban regained power in 2021. By late February 2026, Pakistan's defense minister described the situation as "open war." Islamabad accuses the Taliban administration in Kabul of harboring armed fighters, especially the Pakistani Taliban (TTP), a group distinct from Afghanistan's rulers. Afghan officials deny the charge, arguing that Pakistan tolerates hostile groups and fails to respect their sovereignty.
The majority of male victims were linked to an airstrike on March 16 targeting a drug treatment hospital in Kabul, which only admitted male patients. The attack killed at least 269 people and wounded 122, though UNAMA notes that "the actual number may be significantly higher" because many bodies were "unidentifiable due to severe burns."
UNAMA has called on all warring parties to respect international law by avoiding attacks on medical facilities and refraining from shelling or dropping grenades in civilian areas. In a written response, Pakistan said its actions "target only terrorist and military infrastructure."
The leading cause of civilian casualties, UNAMA says, was airstrikes (64%), with the remainder from cross-border shelling and one "targeted killing" of an NGO worker. An Afghan female NGO employee in Nuristan province was killed on March 19, during Eid al-Fitr, despite a ceasefire agreement reached the day before. The report states: "The NGO worker was shot in the right hip, fell into the water, and drowned along with her three-year-old son."
Following ceasefire talks in China in early April, Pakistan and Afghanistan reportedly committed to avoiding further escalation. Incidents have declined but not stopped entirely. According to Afghan authorities, seven civilians were killed and 85 wounded in shelling on April 27 at a university in Asadabad, Kunar province.
