Eastern Europe and Central Asia (EECA) represents a diverse region facing complex healthcare challenges, including resource constraints, fragmented systems, and limited access to evidence-based decision-making tools. Health technology assessment (HTA) offers a critical framework for addressing these issues by informing efficient allocation of healthcare resources. In April 2024, HTA International (HTAi) convened a policy dialogue in Astana, Kazakhstan, bringing together stakeholders from 12 EECA countries and international experts to discuss HTA advancement in the region. The dialogue highlighted systemic barriers, including political instability, capacity shortages, and fragmented data sources while exploring successful HTA implementation models in some countries. Participants emphasized the importance of political commitment, institutional frameworks, and capacity building, alongside fostering stakeholder collaboration. International organizations such as HTAi and WHO were recognized as vital enablers for technical support and knowledge sharing. Key outcomes included actionable recommendations: strengthening political advocacy, developing legal and institutional frameworks, investing in workforce development, and enhancing multistakeholder engagement. The dialogue underscored HTAi's role in catalyzing regional collaboration, providing platforms for discussion, and offering resources for capacity building. Future initiatives will focus on addressing structural weaknesses, promoting transparency, and embedding HTA into national healthcare systems to ensure equitable and evidence-based decisions. The findings reinforce the potential of HTA to enhance healthcare policy and planning in EECA, fostering resilient systems that better meet population health needs despite ongoing challenges.