This study examines governance in Madhesh Province by exploring gaps between constitutional provisions and their practical implementation. It assesses governance quality, identifies key problems, and recommends solutions for improvement.The Constitution of Nepal 2015 guarantees the people's basic rights to food, drinking water, education, health, housing, fairness and justice, etc., which still remain largely unfulfilled.The province's weak governance is transparently reflected in its persistent poverty, chronic unemployment, severe malnutrition, drinking water crisis, poor public service delivery and idespreadcorruption.Despite the existence of the primary constitutional bodies like executive, legislative and judiciary, the province government is ineffective in ensuring the good-governance, delivering the quality public services, protecting and fulfilling the people's basic rights, and gaining the prosperity. Needless to say that the province is constituted of 8 districts and 136 municipalities and rural municipalities. The Chief District Administration Officers ( CDO ) and the Sperindents of Police ( SP ) are appointed by the federal government regardless of the provincial autonomy. And, the municipalities and rural municipalities are autonomous and powerful local bodies. Unfortunately, the Judiciary is miserably weak.The provincial government is really powerless and faced with several challenges.The key challenges are the lack of intergovernmental coordination, inadequate budget, untimely release of funds, assignment of responsibility without delegation of a proper authority, bureaucratic and staffing problems, weak capacity, lack of accountability, policy ambiguity and implementation gap and weak checks and balances mechanism. The remedial measures need to be adopted without any further delay are: maintaining a proper coordination among three levels of government, avoiding intervention in one another's internal affairs, allocating budget reasonably, releasing funds timely, assigning responsibility with a proper delegation authority, managing over / under staffing properly, enhancing provincial capacity, sorting out policy ambiguity, strengthening bureaucracy and judiciary, practising good-governance principles ( Accountability, Responsibility, Transparency, Participation, Rule of Law, Efficiency and Effectiveness and Equity and Inclusiveness ) sincerely, abiding by political ethics and prioritizing the national interest over the partisan and personal ones.