Whenever the performance of a project falls outside nominal values, it is judged to be a project in distress and likely to fail unless some intervention strategy brings it back under control. The objective of this study was to identify the root causes of project distress, the effects of distress, and recovery strategies of project implementation distress. In this study both quantitative and qualitative research designs have been used. Laska-Salayish design and construct road upgrading project was taken as a case study and data was collected from client, consultant, contractor and local administrative officials using questionnaires, interviews and focus group discussion. The questionnaire had a list of factors of which the respondents were asked to rank each according to the three point likert scale. The data obtained was analyzed by using Relative Importance Index (RII) and the factors were ranked accordingly.rnFindings of the study indicated that the top major causes of delay include: Lack of accurate execution planning and estimates of resources, lack of adequate controlling and monitoring systems, lack of resources, change orders, turnover of personnel, landslides, incompetent project team, poor communication system, exceptional adverse climatic conditions, lack of proper risk management system, poor decision making process, right of way (ROW) obstructions,rnThe results obtained indicated that the top major effects of delay include: Cost overrun, overall economic impact in the region, time overrun, negative social impact, and dispute.rnTo mitigate slippages in the project, top effective recovery strategies have been identified. These include: Properly re-planning the project, replace the existing non-performing project team, realizing adequate control and monitoring system, improving communication (stakeholder management), employing appropriate risk management system and resolving problematic technical issues, increase the budget.