Primary health care in Brazil is well-organised, the result of sustained commitment to providing high quality primary health care for the whole population. Brazil has implemented a set of reforms over the past decades to improve the distribution of doctors, develop new forms of service organisation, introduce new financing models, and implement a range of quality improvement initiatives. This review uses internationally recognised indicators and policy frameworks to examine the performance of primary health care in Brazil. While the review points to notable successes, Brazil continues to face challenges as its population ages, risk factors such as obesity are on the rise, and emerging pandemic threats require resilience and adaptability. The report points to key actions that Brazil should consider in the coming years to strengthen performance of primary health care, especially screening and prevention for major non-communicable diseases, improve quality of primary health care provision, address workforce shortages and pursue a digital transformation. A companion publication with a health system review of Brazil examines the main challenges and approaches needed to improve the performance of the Brazilian health system.