The Eastern Mediterranean Region of the World Health Organization is facing an increasing burden of vector-borne diseases. Progress in controlling these diseases is compromised by the limited number of vector control interventions, most of which rely on the use of pesticides. Seventeen countries of the Region participated in a global survey that aimed to map and document registration and management practices for public health pesticides. This paper aims to draw the attention of policy- and decision-makers to the challenges the Region is facing in managing public health pesticides properly to control disease vectors and, based on the outcome of the survey, recommends a set of actions to guide national policy and to strengthen national capacity for the sound management and judicious use of public health pesticides.