This systematic literature review investigated school counselling needs in East and Southeast Asia based on 109 studies from 14 countries published since 2011. School counselling needs were categorised using an international taxonomy (Morshed & Carey, Citation2020, Development of a taxonomy of policy levers to promote high quality school-based counseling. Journal of School-Based Counseling Policy and Evaluation, 2(2), 95–101). We found similarities and differences between the countries and nine main needs characterising the region. These include the need for (1) up-to-date training, (2) country specificmodels of school counselling practices stating school counsellors’ roles and responsibilities, and (3) overcoming societal-level barriers such as stigma towards mental health. We recommend context-sensitive steps to policymakers seeking to improve school counselling services.