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Background and objectives Cancer is a major health issue globally, and in India's Northeast Region (NER), it is experiencing the highest incidence, particularly among rural and tribal communities. However, screening rates are low, awareness is limited, and access to care is challenged by isolation, poor infrastructure, financial constraints, and dependence on traditional medicine. To address these gaps, this scoping review aimed to synthesise evidence on the multidimensional barriers to cancer care in the NER, examine how socioeconomic, cultural, health system, logistical, and geographical factors influence care-seeking behaviour, and identify facilitators that could improve access to screening, diagnosis, and treatment. Methods A scoping review was conducted following the Arksey and O'Malley framework and reported in accordance with PRISMA-ScR guidelines. PubMed, Scopus, Web of Science, and EMBASE were searched for studies published from January 2010 to June 2025. Eligible studies that examined barriers or facilitators to cancer care in the 8 Northeastern States were thematically synthesised. Results Twelve studies were included; barriers were categorised into socioeconomic, health system, cultural, logistical, and geographical domains. Key issues included financial hardship, low health literacy, inadequate infrastructure, transport difficulties, and limited insurance coverage. Facilitators included family support, trust in community health workers, health education, outreach services, and financial incentives. Interpretation and conclusions Cancer care access in the NER is constrained by multidimensional barriers but supported by community and system- level facilitators. Decentralised services have expanded financial protection, and culturally tailored interventions are critical to strengthening cancer care in the region.