Pearl millet is an important food crop in the arid and semi-arid tropical regions of Africa and Asia. Iron and zinc deficiencies are widespread and serious public health problems worldwide, including in India and Africa. Biofortification is a cost-effective and sustainable agricultural strategy to address this problem. The aim of this review is to provide the current biofortification breeding status and future directions of the pearl millet for growing nutrition markets. Research on the pearl millet has shown that a large genetic variability (30–140 mg kg⁻¹ Fe and 20–90 mg kg⁻¹ Zn) available in this crop can be effectively utilized to develop high-yielding cultivars with high iron and zinc densities. Open-pollinated varieties (Dhanashakti) and hybrids (ICMH 1202, ICMH 1203 and ICMH 1301) of pearl millet with a high grain yield and high levels of iron (70–75 mg kg⁻¹) and zinc (35–40 mg kg⁻¹) densities have been developed and released first in India. Currently, India is growing > 70,000 ha of biofortified pearl millet, and furthermore more pipeline cultivars are under various stages of testing at the national (India) and international (west Africa) trials for a possible release. Until today, no special markets existed to promote biofortified varieties and hybrids as no incentive price to products existed to address food and nutritional insecurity simultaneously. The market demand is likely to increase only after an investment in crop breeding and the integration into the public distribution system, nutritional intervention schemes, private seed and food companies with strong mainstreaming nutritional policies. The following sections describe various aspects of breeding and market opportunity for addressing micronutrient malnutrition.