This paper have analyzed the existence of PHCs in the enhancement of health care delivery in Nigeria over the last four decades. The study, specifically examined the evolution and the structure of the Primary Health Care delivery system in Nigeria. It also determines the PHC programs and assesses the performance and functioning of the activities. Similarly, the study examined the extent of community participation in the program and the contributions of the government in sustaining the system. The challenges and necessary commitments were identified that need to be addressed if PHC is to remain relevant in a large country such as Nigeria. Revitalizing PHC principles without developing a framework to address concrete measures for health improvements is not sufficient. The challenges and policy recommendations made by stakeholders and users of PHCs discussed in this paper need to be examined in a systematic and integrated way to produce flexible policy options and solutions that can be implemented. To do this, particularly in a time of financial and security challenges which Nigeria is currently facing, requires a willingness to dialogue and appreciate a range of different and often contradictory views working toward consensus.