During the innings on Wednesday, Lara surpassed legendary Australian batsman Don Bradman's record of 18 scores of 150 and above and came within 96 runs of becoming the first man to score 12,000 runs in Test cricket.
The home team reached lunch at 21-0, still needing another 213 runs to avoid an innings defeat. Openers Mohammad Hafeez (17) and Imran Farhat (4) were unbeaten at the crease at the interval.
The West Indies trail the three-match series 1-0 after they lost the first Test by nine wickets in Lahore last week.
Lara notched his ninth double century in the West Indies score of 591 runs in the first innings. The tourists took a lead of 234 runs over Pakistan's first innings score of 357.
Their innings becomes the highest total they have ever scored against Pakistan in Pakistan, surpassing 493 they scored in Karachi in 1974.
Lara, 196 overnight, took a single and then drove fast bowler Umar Gul through the covers for three runs to complete his career's ninth double hundred.
His double century came off 241 balls and contained 21 boundaries and seven sixes. He hit another boundary off Gul before holing out at long-on, where Shoaib Malik took a straightforward catch off leg-spinner Dansh Kaneria.
His stroke-filled innings of 216 lasted six hours and 23 minutes.
Kaneria, who suffered Lara's scourge Tuesday, finished with 5-181.
The tourists lost Denesh Ramdin to fast bowler Shahid Nazir for 11 after they resumed the day at 509-5 before Kaneria got into the act with Lara's prized scalp and then removed Dave Mohammed for 36.
Mohammed hit two sixes and two boundaries to further compound home bowlers' miseries.
Paceman Abdul Razzaq wrapped up the West Indian innings by dismissing Daren Powell (nine) and Jerome Taylor (one) in the space of four deliveries to finish with 2-65.
Pakistan 357 and 21/0 (Mohammad Hafeez 17, Imran Farhat 4) Vs West Indies 591 all out (Brian Lara 216, Chris Gayle 93, Darren Ganga 82, Dwayne Bravo 89; Danish Kaneria 5 for 181, Razzaq 2 for 65)