This paper reviews the International English Language Testing System's speaking sub-test in the East Asia region with reference to theoretical and practice-based perspectives and identifies future research opportunities to enhance the measures of test qualities found. The test's construct validity was seen to accurately measure the abilities defined in the IELTS speaking construct; however, high reliability was revealed to the detriment of other test qualities. Conclusions drawn indicate three primary facets of test qualities that could be addressed to increase the IELTS speaking sub-test's usefulness and therefore effectiveness in the East Asian regional context, although these test quality improvements could also be considered as beneficial when applied on a global scale. Firstly, content developers and item writers could provide a greater degree of test item content relevancy to the characteristics of a changing test-taker population. Secondly, multiple future research collaborations between the IELTS partners and institutional test score users seeking to provide better evidence of predictive validity would be beneficial to counteract the lower degree of authenticity shown. And finally, a re-intensification of efforts enhancing positive washback for test takers and exam preparation course providers within the East Asian region is essential.