Background: Systematic reviews (SRs) become more and more important for the healthcare decision- and policy-makers nowadays. The SRs development varies in countries of Asia-Pacific region. Different promotion strategies are required to develop the SRs for countries in the region. Objectives: To identify the current development and influence factors to SRs publication in the Asia Pacific region. Methods: We compared the performance of 11 selected countries/regions with regard to their published SRs retrieved from PubMed during 1989–2008. Other social and healthcare determinants, such as, the total number of physicians, and gross domestic product were also taken into account. Results: Of the 11 studied countries/regions, Australia produced over half of the SRs (51%), followed by China (10%), Japan (10%), New Zealand (9%), Hong Kong (5%) and India (5%). A comparison of the overall health science publications indicates that Australia, New Zealand, Hong Kong, Singapore, and Thailand had relatively high productivity in SRs. The ranking was similar as we carried out the analysis by taking into account of the total number of physicians in each country. Further analysis showed that fewer than 5% of SRs were published in Cochrane Database of Systematic Review (CDSR) in Japan, South Korea and Taiwan. Conclusions: Among the Asia-Pacific countries and regions, Australia has set an outstanding example in the development of SRs. To some extent, New Zealand, Singapore, Hong Kong, China, and India have also contributed significantly to this body of knowledge. Japan, South Korea, and Taiwan can improve more in producing SRs, in particular Cochrane SRs. The findings re-addressed that building the capacity of SRs required supports from both local government as well as regional Cochrane entities. To bring together all research partners in the region, particularly those with Cochrane entities, is crucial to reduce unnecessary barriers and accelerate the progress in SRs research.