This chapter examines the evolving landscape of mental health care in the Middle East, highlighting systemic disparities in service delivery, workforce distribution, and infrastructure across fourteen countries, including Bahrain, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Oman, Palestine, Qatar, Saudi Arabia, Syria, the United Arab Emirates, and Yemen. Drawing on data from the World Health Organisation Mental Health Atlas, it identifies persistent structural challenges while showcasing country-specific innovations in digital health, decentralised care, and culturally adapted interventions. The chapter draws attention to the predominance of cross-sectional studies and advocates for increased investment in implementation science and regional collaboration. It emphasises the region’s unique strengths, faith integration, family-centred care, and collectivist resilience, which contribute to the global mental health discourse. It concludes with a forward-looking agenda, advocating for community-oriented, system-strengthening reforms that are culturally grounded and contextually appropriate, positioning the Middle East as a site of ongoing challenges and a source of scalable solutions for the region.