ABSTRACT We present a new model of radially anisotropic seismic wavespeeds for the crust and upper mantle of a broad region of the Middle East and Southwest Asia (MESWA) derived from adjoint waveform tomography. The new model enables fully 3D simulations of complete three-component waveforms and provides improved fits that were not possible with previous models. We inverted over 32,000 waveforms from 192 earthquakes recorded by over 1000 openly available broadband seismic stations from permanent and temporary networks in the region with highly uneven coverage. Inversion iterations proceeded from the period band 50–100 s in six stages and 54 total iterations reducing the minimum period to 30 s. Our final model, MESWA, improves waveform fits compared to the starting and other models for both the data used in the inversion and an independent validation set of 66 events. Restitution tests indicate that the model resolves features in the central part of the model to depths of about 150 km. The new model reveals tectonic features imaged by other studies and methods but in a new holistic model of anisotropic shear and compressional wavespeeds (VS and VP, respectively) covering a larger domain with smaller scale length and amplified features. Examples include low crustal VS in the Tethyan belt and low mantle VS following divergent (Gulf of Aden, Red Sea) and transform (Dead Sea fault) margins of the Arabian plate. Low VS is imaged below Cenozoic volcanic centers of the Mecca–Madina–Nafud Line, Arabian Peninsula, and the Türkiye–Iran border region. Elevated VS tracks Makran subduction under southeast Iran with near vertical dip. MESWA could be used as a starting model for further improvements, say, using waveforms from in-country seismic networks that are not currently openly available and/or smaller-scale studies targeting a shorter period. The model could be used to improve earthquake hazard studies and nuclear explosion monitoring.