The growing attention for food systems in policy debates has highlighted the systemic linkages between desired food system outcomes. There is an increased recognition that systemic changes are required to improve access to healthy, sustainable diets. While there is abundant academic analysis on the global need for food system transformation, regional differences in food system transformation priorities have received limited scholarly attention. This article aims to address this gap by analysing the results of a regional consultation study about respondents’ perceptions of the needs and modalities for food systems transformation. Data collection consisted of an online survey among 621 agri-food professionals and in-depth interviews among 33 food system experts from different regions across the world. The study shows how different stakeholders across the world prioritise food system drivers, food system challenges and food system transformation strategies. Region, organisational background, countries’ level of food system transformation, political and socio-economic structure are critical factors in determining such priorities. The study highlights relevant food system differences and priorities between food system actors. These differences have important policy implications for the agendas of stakeholders in their regional priorities in food systems transformation. While there is much agreement across regions on the key drivers of different food system challenges, which food system challenge is considered most urgent and which food system transformation strategy deserves most priority, differs greatly between regions. This article shows the importance of including regional and local perspectives in policy debates on the directions food system transformations should take and the need to identify such differences methodically.