This article deals with the government challenges, efforts and fertility situation of Nepal. The major objective of this paper is to know the level and consequences of high fertility in the development process of Nepal and what will be the government have to efforts on the socio-economic sectors and improved quality of live through desired family size. Secondary data are used from 1971-2011 censuses, Demographic Health Surveys (DHS) (2001, 2006 and 2011) and Nepal Living Standard (NLSS) Survey, 2010/11. Development is itself the best contraceptives. Nepal cannot afford to wait until it achieves a certain level of development at which fertility starts declining. It will be too late. The challenges have emerged i.e. high population growth through high fertility and low level of mortality. To explore the prospects for further fertility decline through access proper health facilities, use of contraception, family planning, increased role and involvement of women in socio-economic sectors among who have high fertility. There is a need of adoption of pragmatic methods of compatible to the social norms and values to avert the births and Strengthening of the knowledge base on the effectiveness of public health strategies to reduce mortality (IMR &MMR;) is urgently required but will need concerted action and international commitment.