Over the last five years, the global clinical trial landscape has changed significantly. During the analysis period between 2017-2021, over 70,000 new clinical trials were registered in the APAC region, the US, and the EU5. The APAC region was the largest contributor, with more than 50% of the trials followed by the US (29%) and the EU5 (17%). During this period, the highest growth was witnessed in the APAC region (CAGR of 14%), while the US grew marginally, and negative growth was observed in the EU5. The APAC region has become the preferred destination for conducting clinical trials due to its large patient population, ease of regulatory compliance, low cost of conducting studies, high-quality standards and the presence of top clinical institutions acting as sites. Notably, China’s regulatory reforms have accelerated drug approval by reducing the overall review and process. China recorded the largest number of new trials during the assessed period, followed by the US and India; China and India together accounted for ~40% of the total trials recorded among the countries of interest. In China, the number of new trials doubled during 2017-2021. However, the US remained steady primarily from 2017-2020 with a slight increase in 2021. This indicates that the onset of the COVID-19 pandemic did not significantly impact China’s research activity. The growth in the US in 2021 was amid increased research due to the pandemic.