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, 2020, 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 specific models 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. Highlights: School counselling needs across East and Southeast Asia present certain similarities such as the need to provide school counsellors with up-to-date, relevant training, and the need for the school counselling profession to be guided by a specific school counselling model. The Taxonomy of Policy Levers to Promote High Quality School-Based Counselling is a useful tool to identify specific levers to improve school counselling services. New levers are suggested focusing on providing up-to-date training and regular supervision to school counsellors, aligning school counselling policy with the school environment and taking initiatives to overcome societal level barriers such as stigma towards mental health.