In India and Pakistan, CVD and diabetes has assumed alarming levels. However,governments in these countries are ill-prepared for coping with this epidemic. This paper reviews the literature for those studies which have addressed the current and foreseen economic and social consequences of CVDs and diabetes in India and Pakistan. This review adopts a societal perspective by incorporating the impact on the individual, the household, and the health and economic sectors. The review finds that in both countries there has been a paucity of systematic efforts to measure the economic and social impact of CVDs and diabetes. Moreover, the review has found an absence of assessments of direct and indirect costs in the same study, inattention to the social consequences of these diseases and methodological inconsistencies which make comparative analyses restrictive. It is critically important that a research base of studies investigating the impact of the diseases in India and Pakistan be undertaken. Gathering these data is critical since both countries have many competing health priorities reflected in the intransigency of key health indicators and the data emerging from these countries suggests that the social gradient is reversing. Therefore, in the absence of hard evidence to these diseases are likely to remain outside of mainstream public health planning. With these data in hand, the choice for health planners with regard to important decisions may become clearer. Similarly, the implications for productivity and revenue earnings make a powerful argument in order to focus the attention of private sector employers on these issues.