As a result, Multan has been transformed, residents say. The city is ribboned with new roads and expressways, while a modern airport, capable of accommodating wide-body jets, is near completion. The railway station has been overhauled, some neighborhoods have new sewerage and young students have been awarded generous scholarships.

A giant billboard outside Mr. Gilani’s house lists his achievements: 34 major development projects, costing more than $280 million, all financed by Pakistani taxpayers. “Multan has become like Paris for us,” said Muhammad Bilal, a 28-year-old laborer and enthusiastic Gilani supporter, at a rally last week.

As Mr. Gilani bumped down a country lane on the way to that rally, he pointed to a line of female faces peeking over a wall: all beneficiaries of a government aid plan he helped establish that pays $10 a month to poor women, he said.

“This is a backward area,” the former prime minister, a soft-spoken and amiable man, said just before supporters showered him with rose petals. “People have issues regarding their personal needs.”

To critics like Mr. Khan, this type of politics represents the rot in government: the cornerstone of an unfair system riddled with graft and nepotism. But political scientists say it may be unavoidable in a country with limited resources and a weak government.

“The debate is misplaced,” said Asad Sayeed of the Collective for Social Science Research in Karachi. “To do away with the demand for patronage politics, you would need to rebuild the entire state.”

In a country where politicians have competed with military generals for power, patronage is also a prominent tool of civilian influence. While the military enjoys a largely unscrutinized budget, politicians depend on public resources to build legitimacy.