<p>Carbapenem-resistant Enterobacterales are defined as Enterobacterales which are resistant in vitro to any carbapenem antimicrobial or are documented to produce a carbapenemase. They are a serious public health threat and are listed as critical pathogens on the World Health Organization’s (WHO) list of priority pathogens. Critical pathogens are antibiotic resistant pathogens which pose the highest threat to public health due to limited treatment options, high disease burden, high rates of treatment failure, high transmissibility, increased healthcare costs and increasing trends in antibiotic resistance, with few or no promising antibiotic candidates in the research and development pipeline. When treatment failure due to CRE occurs, physicians are left with few antibiotic alternatives, most of which have high toxicity profiles. While CRE are of public health importance, globally, their problem is exacerbated in Low and Middle Income Countries (LMICs) due to reasons such as poor diagnostic microbiology capacity, data gaps due to poor surveillance structures, inadequate antibiotic treatment options and poor infection prevention and control protocols and ultimately poor patient outcomes. Also, rising rates of CRE infections and infections caused by other multidrug resistant (MDR) organisms could result in a failure to achieve the health related sustainable development goals, due to increased healthcare costs, poverty and reduced productivity. Efforts to adequately combat CRE infections in LMICs must therefore involve context specific and sustainable solutions. The aim of this review, therefore, is to discuss the challenge of CRE in LMICs and offer recommendations to curb the menace posed by CRE.</p>