Neither India nor China has a formalized trauma system in place. There are many similarities between the 2 countries in terms of size, rapid economic growth, increasing number of motor vehicles, and high rates of road traffic accident (RTA) fatalities. This paper describes the current development of elements of the trauma system in China and the strategies and efforts made to improve the trauma system in India. In China, though not organized and formalized, different phases of the trauma system are present at varying levels of maturity. In India, efforts are made to implement a trauma system by mainly focusing on preventive measures and the creation of trauma designated facilities. Although progress has been made, the concept of “adequate trauma care for all” continues to remain an aspiration in many Asian countries, including India and China. Continued and concerted effort across many levels will be required to achieve this goal.