Problem-based learning (PBL), has been in existence for half a century as of 2019 and still remains the most innovative medical education innovation due to its revolutionary pedagogical approach characterized by student-centered learning (SCL) and self-directed learning (SDL) using simulated real-life scenarios as the learning platform. Here, learning becomes more self-driven, meaningful and relevant, pertaining to the social accountability principle of higher education. Being popular worldwide and driven by a strong demand for medical education reform during the past two decades, PBL has rapidly swept across the medical education communities in Asian countries. Many medical schools in Asia were drawn in by the innovative pedagogical methodology that PBL embraces, but tended to neglect with time, often unintentionally, the philosophy that PBL embodies. As a result, PBL in Asia, for various local academic, cultural, economic and administrative reasons started drifting away from its intended educational purposes. Consequently, the acceptance and practice of PBL in Asia has taken compromised forms as PBL-hybrids embedded within long existing and incorrigibly traditional curricula, or other less effective forms for easier implementation and management, at the expense of SCL and SDL. PBL in health sciences education, which has had a 50-year flourishment in the West, remains a continuous struggle in Asia. PBL for health science education in Asia is certainly no panacea, and is probably heading for a thorny path, despite the ultimate hope for a promising future.