South Asians (SAs) represent an increasing proportion of North American populations and demonstrate excess cardiometabolic risk. Multiple factors likely contribute; however, much is not yet known about what leads to this excess risk. Diet composition, physical activity, and mental health are important lifestyle contributors. Specific adverse pregnancy outcomes are higher in SA women and represent an early opportunity for intervention. More broadly, comprehensive assessments of adiposity, diabetes, hypertension, dyslipidemia, coronary atherosclerosis via imaging, and genetic risk may improve detection and awareness among SAs and those treating SAs. At an individual level, culturally tailored preventive clinics may foster awareness and detection, leading to improved prevention and management of cardiometabolic risk. At a community and population level, assessments of the impact of social determinants, acculturation, and the environment may lead to broader initiatives to improve health in SAs. Lastly, supporting expanded investigation, policy, and other health and science measures at an institutional and societal level may lead to broad but impactful changes across the North American diaspora. In this clinical practice statement, we aim to provide a roadmap of the path forward in each of these domains for health care providers and health systems, community outreach groups, and stakeholders invested in investigation and policy to mitigate risk and empower SAs to lead healthy lives.