The 2025 Health Technology Assessment International (HTAi) Regional Meeting for the Middle East and North Africa (MENA) was held in Tunis, Tunisia, in September 2025. The meeting, coorganized with the Tunisian National Authority for Assessment and Accreditation in Healthcare (INEAS), focused on advancing equitable, efficient, and innovative health systems through institutionalized HTA practices. Across three core sessions – regional HTA development, system functionality and resilience, and access to medicines – participants shared national experiences, challenges, and collaborative opportunities. Key outcomes emphasized building enabling environments for HTA, capacity development, multi-stakeholder collaboration, and integration of HTA into governance and financing systems. This article highlights lessons learned and identifies strategic recommendations for fostering sustainable HTA growth across the MENA region.