In 2026, 4.5 million girls, including many under the age of five, are at risk of female genital mutilation (FGM). More than 230 million girls and women live with the lifelong consequences of this practice, which threatens physical and mental health and causes serious complications with an annual treatment cost of approximately US$1.4 billion. Over the past three decades, interventions have reduced the risk of FGM from one in two to one in three girls in countries where it is common, with half of the gains since 1990 achieved in the last decade. Almost two-thirds of the population in these countries support its elimination. Effective strategies include health education, involvement of religious and community leaders, parents, health professionals, and use of the media. An investment of $2.8 billion can prevent 20 million cases with a return of $28 billion. UN leaders are calling for sustained funding to meet the goal of ending FGM by 2030, as declining investment threatens progress.