The development of sensitive and specific serological assays for celiac disease has led to a revision of the prevalence of this disease in many countries. In the Asia-Pacific region, prevalence has been determined in only a minority of countries but those with prevalence rates of 1:50-1:500 adults include Australia, Iran, Israel, New Zealand, Syria and Turkey. In contrast, celiac disease appears to be extremely rare in Japan and may be rare in China. In India, prevalence rates are high in the northern states but much lower in the southern states. In individual countries, important determinants of prevalence include the per capita consumption of wheat and the frequency of a specific human leukocyte antigen (HLA) type genetically defined as HLA-DQB1*02 (*0201 or *0202) and serologically defined as HLA-DQ2. These determinants predict low prevalence rates for celiac disease in the Pacific Islands, South-East Asia and eastern China but higher rates in countries west of India and China. There is also the potential for a rising incidence of celiac disease if traditional rice-based diets are replaced by Western-style diets with a higher content of wheat products.