This chapter surveys the studies on writing difficulties (i.e., difficulties in spelling and written composition) among students with learning challenges in Mainland China, Taiwan, Hong Kong and Japan, where the Chinese orthography plays an important role in literacy development. Although each of these countries/regions has a unique history and pace of research development concerning writing difficulties, their trajectories of research are similar. Most of the early research focused on identifying the characteristics and subtypes of writing difficulties, followed by explanatory research to examine the factors for predicting the underlying writing difficulties, and finally intervention studies on how to better support students with writing difficulties. Three directions are recommended for future research: (1) to pay more attention to the affective-motivational aspects of writing, (2) to develop innovative and evidence-based intervention programmes that are tailor-made to the characteristics of writers in these Asian countries/regions and (3) to adopt the interdisciplinary and multidisciplinary approaches in conducting research and supporting students with writing difficulties.