This inaugural chapter of the handbook’s third section on gender and health systems comprises three sections: frameworks, regional evidence of note, and a description of the 16 chapters in the section. The frameworks section describes the classic 2000 World Health Organization health systems building blocks framework, its adaptations and updates, and the right to health framework instantiated by the AAAQ model. It then examines each component of the extended building blocks framework using a gender lens and presents the RinGs consortium framework on gender equitable and transformative health systems. The second part of this chapter describes evidence on gender and health systems from Bangladesh, India, Nepal, Pakistan, and Sri Lanka. Subsections here explore the influence of sex and gender in access to and utilization of health services, gendered quality of care with a focus on facility-based pregnancy and delivery care, gender issues in the health workforce, and finally, the gendered consequences of specific modalities of healthcare financing. The final section of this chapter describes the 16 contributions to this section from Bangladesh, India, Pakistan, and Sri Lanka. Following this, the section also reflects on the methodological range and theoretical contributions of the chapters overall, as well as the centrality of the concept of “lack” in all contributions, positing that future contributions should speak to action and exemplars of transformative change.