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Background Gastroesophageal reflux disease (GERD) contributes substantially to symptom burden, healthcare use, and productivity loss in Asia. This study aimed to evaluate the scale and burden of GERD across Asian regions, sexes, and age groups, providing updated evidence to inform targeted prevention and management strategies.Methods GERD burden was summarized from Global Burden of Disease 2023 estimates for incidence, prevalence, and disabilityadjusted life years (DALYs). We described sexstratified and agespecific burdens, agestandardized rates across Asia, produced country rankings for 2023, and assessed temporal changes as percentage or fold changes from 1990 to 2023 by subregion.Results GERD incidence in 2023 ranged from 0.26 million cases (95% uncertainty interval[UI]: 0.23-0.30) in Oceania to 97.47 million cases (95% UI: 86.69–107.52) in South Asia. Across Asian regions, males had higher incidence, prevalence, and DALY counts than females in most areas; however, the opposite pattern was observed in Highincome Asia Pacific and South Asia, where females experienced higher burdens across all three indicators. At the country level, India recorded the largest number of prevalent cases (198.07 million; 95% UI: 176.84–225.17 million), incident cases (77.49 million; 95% UI: 68.86–85.54 million), and DALYs (1.52 million; 95% UI: 0.77-2.72 million) in 2023, followed by China and Pakistan. Agespecific prevalence peaks varied by region. Prevalence was highest among individuals aged 30–39 years in South Asia, and 50–59 years in East Asia. In 2023, East Asia had the lowest ASIR, ASPR, and ASDALY, whereas the highest rates were observed in South Asia and Central Asia. From 1990 to 2023, incidence, prevalence, and DALY counts increased across all Asian regions, with the most pronounced rise observed in Oceania, where prevalence increased by 1.51 (95% UI: 1.47–1.56)fold, DALYs by 1.51 (95% UI: 1.46–1.58)fold, and incidence by 1.48 (95% UI: 1.44–1.52)fold. Highincome Asia Pacific experienced the smallest increases across all indicators.Conclusions GERD imposes a large and growing incidence, prevalence, and DALYs across Asia, with a femalepredominant burden in Highincome Asia Pacific and South Asia but malepredominant burden elsewhere, and the highest agestandardized rates in South and Central Asia. These consistent upward trends highlight an urgent need for coordinated, regiontailored responses to effectively address shifting population risks.