Objective <p>Gestational diabetes mellitus (GDM) has lasting health impacts on both the mother and the child and has been increasing in low–middle-income countries. Psychological and socio-cultural variables can have a uniquely significant impact on how GDM is navigated and managed. Therefore, this study aimed to synthesize the experiences of women with GDM in the Asian context.</p> Methods <p>A systematic literature search was conducted using PubMed and Scopus databases to identify experiences of women with GDM for the purpose of employing narrative synthesis. Studies were included if they were from Asia and followed a qualitative paradigm.</p> Results <p>Nine studies met the inclusion criteria. The women (<i>N</i> = 219) in the studies faced multifaceted challenges that can be understood as psychological, socio-cultural, and systemic in nature. The common themes were psychological distress regarding the diagnosis and managing the recommended lifestyle and treatment, which were largely attributed to healthcare services, financial constraints, practical difficulties, familial issues, overpowering traditional conflicting recommendations, and lack of a support system. Gendered norms and stigma also compounded the difficulties of many women.</p> Conclusion <p>Despite the limited research on GDM specifically in the Asian context, the findings highlight common challenges and experiences of these women. There is a need for sustainable and culturally specific treatment protocols, greater support from healthcare providers, and increasing community awareness acknowledging the role of informal social support systems. Balancing cultural beliefs and practices with treatment recommendations can significantly improve adherence and reduce distress for women with GDM. Further research is rooted in stronger theoretical frameworks in other South Asian countries to be able to develop sustainable preventive and management programmes.</p>