BACKGROUND & AIM: The prevalence of young onset (≤30 years) type 2 diabetes (T2D) is increasing in South Asians, reflecting rise in childhood obesity. This systematic review analyses current data on thecohort prevalence of young onset T2D in South Asians. METHODS: PubMed, Scopus,Science Direct,and Ebscohost were searched for articles published between 1990 and 2024, anda manual search identified additional articles. This study included case series, cross-sectional, retrospective cohort, or case reports. RESULTS: Out of 5073 studies, 26 eligible studies were found including three case reports. Seventeen studies were from India, five werefrom other South Asian countries (Pakistan, Bangladesh, Nepal, Maldives), and nine were on migrant South Asians residing in different countries (UK,USA,Qatar, Canada). The cohort prevalence of young onset T2D in South Asians ranged from 0.1 % to 28.3 % (India 0.4 to 26.8 %, other SA countries 0.1 to 28.3 %, and migrant South Asians 4.1 to 18.1 %). CONCLUSION: The burden of T2D among native South Asian children and young adults is higher than among migrant South Asians. This contrasts with traditional perceptions that T2D primarily affects older individuals and the South Asian diaspora i.e., those who have migrated from South Asia.