This article presents an overview of the current status of school-based counselling and psychological services for school-going children and their families in Macao. Adopting an eco-systemic model, some recent articles on school-based counselling and psychological services in Southeast Asian countries are reviewed, and similar data from individuals currently providing such services in Macao are examined. Findings show that there is a great need for psychological services, particularly with regard to consultation and intervention for children, youths, and their families, in Macao's fast-changing society. The needs are discussed within a systems framework, and recommendations for the development of the field and the need for additional school-based child and family interventions in the region are discussed.