Access to genetic and genomic healthcare is rapidly expanding globally, contributing to the emergence of genetic counseling practice in various parts of Asia. This scoping review maps the current genetic counseling practices in Asia and the challenges faced by these countries in establishing genetic counseling services. The review was informed by the Joanna Briggs Institute methodology, and five databases were systematically searched. Forty-one unique papers were identified. The data was charted to summarize all available evidence regarding the status of current practices in Asia, which include the composition of the local workforce, their scope of practice, and the problems encountered by countries when instituting genetic counseling practices. Our results indicate countries are at varying stages of establishing practices and experience a host of interdependent challenges that impede the effective provision of services. Challenges include a lack of funding and legislation by governments, a cadre of genetically trained professionals with limited scope of practice, a population with low genomic literacy, coupled with varying language, cultural, and religious practices that influence genetic counseling practices. The findings call for Asian countries to adopt a multi-faceted approach that collectively engages various collaborators, including government and the healthcare workforce, to tackle existing barriers hindering the development of genetic counseling practices locally. Establishing ongoing dialogue between countries could help institute novel solutions to developing genetic counseling services in each country to enhance the advancement of genomic medicine in the region.