Coronavirus disease (COVID-19) caused by SARS-CoV-2 was notified from Wuhan city, Hubei province, China in the mid of December 2019. The disease is showing dynamic change in the pattern of COVID-19 confirmed cases and death toll in these low and middle-income countries (LMICs). In this study, exponential growth (EG) method was used to calculate the reproductive rate (Rt) for initial and current stage of epidemic in South Asian Association for Regional Cooperation (SAARC) member countries (April 2020 - December 2020). Time dependent (TD) method was used to calculate the weekly reproduction number. We also presented the observations on COVID-19 epidemiology in relation with the health expenditure, poverty, and BCG vaccination, literacy, in comparison with the reproduction number, population density for understanding the current scenario, trends, and expected outcome of the disease in SAARC countries. A significant positive correlation was noticed between COVID-19 deaths and health expenditure (% GDP) (r=0.58, P<0.05). The other factors such as population density/ sq km, literacy %, adult population %, and poverty % are not significantly correlated with number of COVID-19 cases and deaths. Among SAARC countries, the highest reproduction number (Rt) was observed in India (Rt =2.10; 95% CI 2.04-2.17) followed by Bangladesh (Rt =1.62; 95% CI 1.59-1.64) in initial state of epidemic. A continuous monitoring is necessitated in all countries looking at the medical facilities, available infrastructure and healthcare manpower, constraints which may appear with increased number of critically ill patients if the situation persists longer.