These are the proceedings from the Conference on Reforming the Public Expenditure Management System, which offered an opportunity to discuss a variety of policy recommendations and proposals. It is expected that these will provide momentum for reforming the public expenditure management system in Korea, and serve as references for fiscal reform in other countries as well. Moving towards a Medium-Term Expenditure Framework (MTEF) involves building upon the current budget and policy decision-making process, with an aim to overcome some of the current incentives in the process and improve public expenditure decisions and management. Discussion papers explore the stages of a MTEF process, the role of some of the key institutions in the MTEF process, and references international practices to illustrate points. Further papers discuss MTEF implementation in Korea through the starting point of reform, key issues for introducing MTEF and top-down budgeting, as well as the successful installation of MTEF to the Korean fiscal system. For comparison purposes, MTEF processes in Sweden, Germany, and in the United States (US) were presented. Discussions papers followed on performance management through an overall framework for reform, and strategy. Outlined were results based budgeting in Australia, and a case study in Sweden and the US. Finally, discussions focused on fiscal transparency, covering public finance in Korea, and the information flow for a successful MTEF operation and its implications for the Government of Korea.