This paper explores the impact of Sino-US competition on the Asia-Pacific and South Asian regions. The competition in these regions revolves around a range of issues ranging from geopolitical and geo-strategic to geo-economic interests. However, the US’s Asia policy poses a challenge to Asia’s leading power, China. This article investigates factors behind Obama administration’s policy of Asia Pivot and the policy options available to the present Trump administration and implications for the Asia-Pacific and South Asia regions. An over-emphasis on a hard military-only approach would also be viewed in the South Asia context, where China has adopted an economic approach to extend its influence. A hard approach would have adverse implications for strategic stability in South Asia between India and Pakistan, and there is a possibility of an escalation of tensions between China and its US-allied neighbouring states over maritime disputes.