Emergency contraception (EC), medications or devices used post-coitally to reduce the risk of pregnancy, represents a relatively new reproductive health technology in the Arab world. In 2001, Tunisia became the first country in the region to register an emergency contraceptive pill (ECP). In the subsequent eight years, EC has become fully integrated in both the public and private health systems and in 2005 ECPs were made available directly from pharmacists without a prescription. Distribution of EC has steadily increased in Tunisia and in 2008 approximately 30,000 units of ECPs were obtained by women through retail pharmacies. Although Algeria, Egypt, Lebanon, Libya, Morocco, and Yemen have also registered ECPs, outside of Tunisia regional access to this important method of contraception remains limited. This paper explores the political, medical, and socio-cultural discourses surrounding the introduction of EC in Tunisia. Unlike many countries that have introduced ECPs there appears to have been remarkably little controversy surrounding expanding access to EC in Tunisia. Through a combination of qualitative and quantitative methods, including a survey of retail pharmacists and focus group discussions with unmarried women, this paper chronicles the history of EC in Tunisia and argues that the lack of controversy is directly tied to Tunisia’s overall commitment to providing comprehensive reproductive health services. The lack of politicization of EC in Tunisia is, in part, the result of longstanding reproductive health policies and services that are explicitly linked to women’s political, economic and social status. By situating EC in the broader reproductive health and development agendas, the Tunisian experience highlights how country-specific political, public health, and socio-cultural contexts can support and facilitate the adoption of a global reproductive health technology. By presenting the Tunisian experience, this research can inform broader regional efforts to introduce ECPs and incorporate EC into reproductive health and family planning services.