Zoonotic trematodes Schistosoma japonicum, Fasciola hepatica and Fasciola gigantica are neglected tropical diseases imposing significant health and livestock burdens in Asia. Control remains uneven due to complex host-parasite-environment interactions and fragmented surveillance. Both species utilise aquatic snail intermediates and hepatobiliary tropism, presenting common challenges for diagnosis, treatment, and control. Agricultural intensification and landscape change reshape human-livestock-environment interfaces, facilitating transmission. Despite progress, diagnostics remain constrained by low sensitivity, variable performance, and limited scalability. This review synthesises advances in parasite biology, transmission ecology, and socioecological drivers, with Malaysia as an illustrative case, and identifies One Health opportunities. We evaluate emerging integrated strategies, persistent barriers, and outline priorities for harmonised diagnostics, strengthened multisectoral surveillance, and community-centred interventions.