This paper contributes to the debate on the Sustainable Development Goals progress by evaluating the MDGs achievements in South Asia and the policy and institutional challenges deriving from such experience. Using cross-country regressions and aggregate indicators of poverty, health, education and gender parity outcomes, we offer three sets of findings. First, comparative evidence shows that, while South Asia has converged with richer regions, there is still significant variation in gender equality, universal primary education, and income poverty achievements across countries. Second, projections based on past trends on where SDGs are expected to be by 2030 reveal that there is a long way to go, where emblematic targets as income poverty eradication may not be met in the populous South Asian countries. Finally, considering the expanded set of development targets in the SDGs and the growth slowdown in South Asia, we argue that further progress would simultaneously require increased public spending on health and education and reforms improving state capacity. A simulation exercise confirms that such a combination of interventions would deliver significant benefits in the region, particularly in areas that are critical to progress on the goals of ‘No Poverty’, ‘Quality Education’, ‘Gender Equality’, and ‘Inclusive Growth’.