Fruit and vegetable (FV) consumption benefits the health of populations, particularly those in East and Southeast Asian countries, which have undergone an unprecedented change in their food environments in the last decade. This current systematic review is the first to study determinants—facilitators, barriers, and moderators—associated with FV consumption in East and Southeast Asia. In a search of the literature, we consulted five electronic academic databases of English peer-reviewed papers published between 2010 and 2020 and found 31 studies. Results of these studies show that individuals strongly perceive FVs as being higher quality and safe and trust in their benefits, and food businesses with modernized systems have significantly fostered the consumption of FVs. A main barrier to FV consumption, however, is financial concerns, exacerbated by food businesses with FV unavailability and urbanization-induced FV price inflation and dietary patterns. Further hindering FV consumption are demographics and shopping patterns. The fragmented and conditionalized findings of the 31 studies require standardized FV consumption measurements. Unlike the impact of FV consumption determinants and their interactions in Western countries, those in Asia, particularly countries other than China, have been substantially understudied. Therefore, as the research gaps in studies of food environments and FV consumption in East and Southeast Asia urgently demand scholarly attention, this paper proposes recommendations that favour the consumption of FVs.