This book addresses how to mitigate regional tensions and enhance cooperative opportunities through well-designed regional institutions and organizations among countries in geographical proximity. We use the case of Central Asia (i.e., Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan) to employ our conceptual framework of ‘externally guided regionalism.’ The following questions guide the study: How and by what forces has Central Asian regionalism evolved, and what are the main characteristics and political implications of the continuously evolving regional institutions? We discuss not only the extra-regional influential actors (i.e., Russia, the United States, the European Union, and China), but also intra-regional initiatives, strategies, and struggles in securing stability and sovereignty. Extra-regional actors’ growing competition over molding their own kind of multilateralism involving this region has contributed to the current direction of Central Asia’s regionalization. Concurrently, Central Asia’s political conditions and constraints interactively contribute to ever-increasing institutional sprawl.