A scoping exercise of mental health services in Sylhet City, Bangladesh, was carried out by two United Kingdom based psychiatrists in 2010 as part of the National Health Service Tower Hamlets Bangladesh Programme. The objectives were three-fold: 1) build on existing knowledge bases to map out the mental health service structure in and around Sylhet City; 2) build the foundations for a link between mental health providers in Bangladesh and the United Kingdom; and 3) consider the role for training by Western mental health workers through facilitating a seminar on psychological therapies in Bangladesh. The scoping exercise provides an in-depth description of mental health services in and around Sylhet City. In addition to mainstream public and private sector services, a number of specialist substance misuse centers that accept individuals returning to Bangladesh from the United Kingdom are described. Individuals in Bangladesh often access traditional and spiritual healers during the course of a mental illness, and these alternative services are also detailed. Progress made in laying the foundations for a future health link is described together with a review of the teaching seminar. Recommendations are made for health professionals and other stakeholders who provide mental health care for service users of Bangladesh origin living in both Bangladesh and the United Kingdom.