Peru has made remarkable progress in delivering healthcare services over the past decades, leading to large improvements in most general population health indicators. Health insurance coverage has increased steadily since the 2009 health reforms. The country is now close to achieving universal health coverage, with the Integral Health Insurance (Seguro Integral de Salud) playing a crucial role in reaching poor and underserved rural communities. However, Peru continues to grapple with a health system that remains both segmented and fragmented, with multiple public sub-systems serving different population groups. The health system still lacks the integration and co-ordination needed to ensure equitable access to high-quality care for all Peruvians. Addressing these challenges requires strengthening quality governance, investing in high-impact healthcare service improvements, and curbing inefficiencies. This review assesses the performance of Peru's health system and provides key recommendations for achieving a more equitable, efficient, and sustainable healthcare system aligned with OECD standards.