Pharmaceuticals have been recognized as contaminants of emerging concern because of their ubiquitous presence in the environment and the potential they possess in causing undesirable ecological effects. Many long term ill effects of pharmaceuticals on humans are still unknown. Pharmaceuticals are recalcitrant to wastewater treatment facilities and their occurrence has been documented in almost all environmental matrices around the globe. Every third pill consumed by the world is synthesized in India, and despite that, much less attention and concern is noticed in documenting pharmaceuticals occurrence report in the Indian context. In Indian environment, pharmaceuticals have been detected in influent and effluent of wastewater treatment plants, surface waters and groundwater systems. Concentration of few pharmaceuticals such as ciprofloxacin (31 mg/L) and fluconazole (236 mg/L) reported in wastewaters of Hyderabad city in India show the highest values compared to pharmaceuticals concentration reported elsewhere in the world. Other pharmaceutical compounds that are detected in Indian matrix in mg/L range include cetirizine, losartan, and voriconazole. Metoprolol (950 µg/L), enrofloxacin (900 µg/L), citalopram (840 µg/L), moxifloxacin (694 µg/L), norfloxacin (420 µg/L), azithromycin (300 µg/L), atenolol (300 µg/L), levofloxacin (200 µg/L) are amongst other pharmaceuticals that have been detected at high concentration. Only a few research groups have paid attention on detecting pharmaceuticals in India. Disparity exists in occurrence data with most of the studies concentrated in southern India. India is amongst the top manufacturer and consumer of the pharmaceutical compounds and with pharmaceuticals occurring at alarmingly high concentration in environmental waters, much needed attention and emphasis is required to conduct nation-wide occurrence study program to fully assess the ecological risks possessed by the pharmaceuticals.