Non-communicable diseases (NCDs) have become the dominant cause of mortality and morbidity across the Asia–Pacific, accounting for up to 85% of deaths in several countries. This chapter provides a comprehensive analysis of the epidemiology, determinants, and policy responses to NCDs, emphasizing the region’s socio-economic diversity and health system heterogeneity. It identifies four key domains essential for progress: primary prevention, early detection, community engagement, and multisectoral policy integration. The discussion highlights how rapid urbanization, environmental degradation, ageing populations, and the nutrition transition have accelerated the NCD epidemic, particularly in low- and middle-income countries and Small Island Developing States. Through comparative case studies, from Thailand’s village health volunteers to Hong Kong’s District Health Centres and Samoa’s faith-based wellness programmes, the chapter illustrates how culturally embedded interventions strengthen health outcomes. It further explores digital innovations, fiscal measures, and cross-sector partnerships that align health with economic and environmental goals. Persistent challenges include inequitable financing, cultural barriers, and fragmented governance. The chapter concludes with evidence-based recommendations for integrating NCD prevention into primary care, expanding sustainable financing mechanisms, enhancing digital equity, and institutionalizing multisectoral governance. Collectively, these insights position the Asia–Pacific as both a cautionary tale and a global model for equitable, data-driven NCD control.