Animal-vehicle collisions (AVCs) represent a major cause of road traffic mortality globally, and they are relatively underreported across most parts of the world, especially in highly biodiverse and human-populated areas. The current systematic review aims to pool and summarize AVC-related human deaths from NHs of India, China, Pakistan, Bangladesh, Nepal, and surrounding countries (like Sri Lanka, Bhutan) over the last five years (2020-2025). Based on PRISMA recommendations, we conducted comprehensive searches of leading databases such as PubMed, Google Scholar, and Web of Science, as well as national government reports, ultimately identifying 47 relevant studies and reports from among 1,256 screened records. The inclusion criteria were peer-reviewed articles, official statistics, and grey literature reporting human deaths directly connected to collisions with animals (wild or domestic) on the roads. Key messages: Human deaths due to AVC are on the increase, with India recording the largest toll: an estimated 1200-1500 human fatalities due to stray animal impact (mainly cattle and dogs) along national highways annually. In Punjab, fatalities increased from 312 in 2020 to 421 in 2022. China has a lower specific report but does include AVCs in the wider road safety data, which accounted for anywhere over 61,000 general road deaths in 2020, to factor some portion of those as being attributed to wildlife encounters. In Pakistan, Bangladesh, and Nepal, these data are patchy, although Nepal records a minimum of 300 animal-related events each year with human victims. Typical causes are excessive speed, insufficient street lighting, and animal migratory routes. Limitations: Underreporting and nonspecific data collection across countries. Guidelines recommend mitigation measures such as fencing, underpasses, and public awareness campaigns to address this avoidable form of mortality. This review drives home the requirement for coordinated wildlife and transport policies across Asia to ease this crossover of public health and biodiversity.