More than half of the world's population live in Asia-Pacific. This region is culturally diverse, with significant disparities in terms of socio-economic status, provision of health care and access to advanced technology. The medical use of ionising radiation is increasing worldwide and similarly within the Asia-Pacific region. In this paper, we highlight the current status in usage of ionising radiation in medicine in the region, and review the legal framework, implementation and activities in radiation protection. Asia-Pacific countries are active in strengthening radiation protection by promoting education and training. Various projects and activities initiated by international organisations such as the IAEA, WHO and ICRP have provided stimulation in the region, but more work is needed to continue to improve protection practices.