Introduction: Vitamin D deficiency affects 30–90% of children across the Asia-Pacific region despite abundant sunshine. Contributing factors include limited dietary intake, air pollution reducing UVB transmission, cultural or religious practices favouring sun avoidance, indoor lifestyles, and dark skin pigmentation. This high prevalence, combined with inconsistent clinical practices and lack of unified regional guidelines, creates an urgent need for evidence-based guidance adapted to Asia-Pacific contexts. Objectives: To develop regionally relevant, evidence-based consensus recommendations for vitamin D supplementation and management in children aged 0–18 years across the Asia- Pacific region under the auspices of the Asia Pacific Paediatric Association (APPA). Methods: An expert panel of paediatric endocrinologists and child nutrition specialists conducted an informal consensus process utilizing GRADE evidence synthesis. A literature review of articles published 2000–2025 on Asia-Pacific regional vitamin D deficiency prevalence data and key international guidelines. Consensus recommendations were developed through iterative expert discussion addressing clinical questions on indications, dosing, screening, treatment, safety , and public health implementation. Results: The panel developed evidence-based recommendations spanning empiric supplementation strategies, ageappropriate dosing protocols, screening and diagnosis approaches, treatment of confirmed deficiency , safety considerations, and public health interventions. Recommendations emphasize universal supplementation approaches, targeted screening for high-risk populations, and coordinated clinical and public health strategies adapted to regional dietary patterns, cultural contexts, and healthcare infrastructure. Conclusions: This consensus provides a comprehensive framework to guide clinical practice and public health policy for reducing the burden of vitamin D deficiency among children in the Asia-Pacific region, with an emphasis on feasibility and local adaptation.