India’s changing PV regulatory framework has been influenced by the incorporation of international standards, including those from the European Medicines Agency (EMA), the World Health Organization Programme for International Drug Monitoring, the Council for International Organizations of Medical Sciences (CIOMS), and the International
Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH). Large-scale public health initiatives, patient populations with a variety of cultural backgrounds, and the existence of ancient medical systems like Ayurveda, Siddha, and Unani are just a few of the distinctive national adaptations that India has made in response to local healthcare circumstances. The convergence of India’s PV rules with international norms is examined in this review, which also identifies characteristics specific to India’s regulatory framework. Overall, the path towards harmonisation has improved India’s standing internationally in the drug-safety ecosystem; but full global equivalency would require continued investment, digital growth, and regulatory modernization.