In the early years of the 21st century, the global strategic focus has shifted from the Atlantic to the Indo-Pacific, making this region the focal point in the foreign and security strategies of most great powers, as well as the strategic competition area between the superpowers - the US and China. To adapt to the fundamental changes in the world and regional situation, the US takes the lead in implementing foreign policy towards the Indo-Pacific region, and at the same time create a foundation to motivate global allies/partners to propose strategic visions and policy priorities to increase advantages and create competitive advantages with China in the region. Faced with the above situation, small and medium countries have adjusted their foreign policies more flexibly to protect their security, economic and development interests. Approaching from the perspective of realism theory, this article will focus on analyzing the political situation in the Indo-Pacific region in the region from 2017 to 2025, assessment of foreign policy choices of small and medium countries.