This review examines the existing frameworks present in the Asia-Pacific region to implement and scale up sexuality education. It includes a systematic review of over 300 national policies, laws, strategic plans on HIV, education, population and reproductive health, and youth in 28 countries in Asia and the Pacific. The review finds that there are still significant gaps across the region in terms of legal and policy frameworks. Of all types of policy documents analysed, education policies and laws were least likely to include content on sexuality education. National strategies and plans on HIV and reproductive health more consistently address the role of sexuality education; however critical interventions such as research; monitoring and evaluation; and youth engagement are underrepresented. The review finds that important progress has been made in curriculum development and delivery; however this is primarily being delivered at secondary level and significant gaps remain in teacher preparation. The review concludes with recommendations to strengthen the policy and legal frameworks in the region to better prepare youth for a healthy sexuality.