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South Asia is a demographically crucial, economically aspiring, and socio-culturally diverse region in the world. The region contributes to a large burden of surgically-treatable disease conditions. A large number of people in South Asia cannot access safe and affordable surgical, obstetric, trauma, and anesthesia (SOTA) care when in need. Yet, attention to the region in Global Surgery and Global Health is limited. Here, we assess the status of SOTA care in South Asia. We summarize the evidence on SOTA care indicators and planning. Region-wide, as well as country-specific challenges are highlighted. We also discuss potential directions-initiatives and innovations-toward addressing these challenges. Local partnerships, sustained research and advocacy efforts, and politics can be aligned with evidence-based policymaking and health planning to achieve equitable SOTA care access in the South Asian region under the South Asian Association for Regional Cooperation (SAARC)., Competing Interests: SZ represents the Association for Socially Applicable Research (ASAR) on the drafting committee of the Maharashtra State Mental Health Policy. He has previously received honoraria from Think Global Health, Harvard Public Health Magazine, and The Hindu. He is on the advisory board of ASAR and Nivarana. JP has received consulting fees from Integra Neurosciences and Johnson & Johnson in the past. GJ was employed by the Rural Surgery Innovations Private Limited. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zadey, Rao, Gondi, Sheneman, Patil, Nayan, Iyer, Kumar, Prasad, Finley, Prasad, Chintamani, Sharma, Ghosh, Jesudian, Fatima, Pattisapu, Ko, Bains, Shah, Alam, Hadigal, Malhotra, Wijesuriya, Shukla, Khan, Pandya, Khan, Tenzin, Hadiga and Peterson.)