Background: Adverse drug reactions are a significant burden on the health system across the world. Paradoxically, a considerable chunk of ADRs is missed or not reported on account of avoidable reasons, resulting in bottlenecks in carrying out the proper management. This problem is much more evident in India and other resource-limited communities than in the prosperous countries of the West. Aim and objective: To provide a state-of-the-art update on pharmacovigilance with special reference to perspectives in India and make appropriate recommendations for improving ADR reporting. Design: The contents are based on a review of English medical literature augmented with the author's first-hand experience in the field over the past more than a decade. Results: Well-organized pharmacovigilance started in India with the launching of the Pharmacovigilance Programme of India in 2010. Despite it making a perceptible improvement in ADR reporting, high underreporting of ADRs still prevails. The yet greater thrust on inculcating awareness comprising knowledge attitudes and practices among the healthcare professionals is likely to lead to further improvement in ADR reporting, resulting in augmentation of the safe use of drugs. Conclusion: Pharmacovigilance, a mandatory drug safety activity, needs to be propagated with yet greater vigor among healthcare professionals in India.