The great increase in rates of cardiovascular disease in developing countries will probably have grave implications for south Asia, which houses nearly a quarter of the world's population. Several factors might contribute to this effect, such as increased susceptibility of south Asian people to cardiovascular disease, unrecognised targets for preventive interventions, and restricted access to high-cost tertiary cardiovascular care for economically disadvantaged communities. Furthermore, prevention and control of cardiovascular disease does not feature prominently in the health care agendas of south Asian countries. To address these issues, therefore, a multifaceted approach is needed, which should include epidemiological studies to fill in the gaps in knowledge. Additionally, political, social, cultural, and economic issues need to be considered in prevention and control of these diseases, to identify and address key limitations and opportunities specific to the region. A set of recommendations outlining the approach is crucial.