Providing care for critically ill patients poses significant challenges in low-and-middle income countries, where the burden of critical illnesses is higher compared to resources-rich settings. Barriers to delivering high-quality critical care in these environments include lack of epidemiological data and specific evidence for making medical decisions, deficiencies in the organization and resources of healthcare systems, and institutional hurdles that hinder the implementation of life-saving interventions. Innovative, affordable solutions that address local needs, such as the development of devices like low cost ventilators or monitors, implementation of adapted clinical protocols and innovation in the definitions or diagnostic criteria are needed to improve the delivery of high-quality critical care and improve global health.