Competency-Based Medical Education (CBME) is a transformative approach in medical training, which emphasizes achieving defined clinical competencies, patient-centred outcomes, continuous assessment, and individualized learning progressions. In psychiatry, CBME is particularly relevant as it fosters critical skills in communication, ethics, cultural sensitivity, and community-oriented care. Across South Asia, the implementation of CBME in psychiatry is varied and evolving. India introduced CBME nationally in 2019, with structured reforms like early clinical exposure and skill labs, though psychiatry-specific implementation remains uneven due to faculty shortages. Sri Lanka, Bangladesh, and Nepal have made gradual progress but continue to face significant challenges in standardization, faculty capacity, and infrastructure. Pakistan has pioneered innovative CBME models in psychiatry through leading institutions like Aga Khan University. Bhutan has embraced CBME fully, aligning it with the country’s Gross National Happiness philosophy, while Maldives and Afghanistan are in the early stages of integration. Regional barriers also include inadequate simulation facilities and persistent cultural stigma surrounding mental health. However, there are significant opportunities for regional collaboration, technology-driven teaching, and shared curriculum development. Moving forward, South Asian psychiatry education must focus on faculty training, policy support, telepsychiatry, and integrating disaster psychiatry, migration stress to address the region’s evolving psychiatric care needs.