Background: Celiac disease, a chronic autoimmune disorder triggered by gluten ingestion in genetically susceptible individuals, is increasingly recognised as a significant health concern in India. This review synthesises recent data on the regional variability in prevalence, emphasising the high rates in North India linked to dietary wheat exposure and the geneti c predisposition conferred by HLA-DQ2 and HLA-DQ8 alleles. The pathophysiology involves maladaptive immune responses to gluten peptides, which leads to intestinal mucosal injury and systemic manifestations. Management remains centered on lifelong gluten free diet adherence, which poses unique challenges in the Indian context due to cultural dietary habits, food labelling limitations, and cross-contamination risks. Nutritional counselling, patient education, and public health initiatives are essential for effective disease control. Further research into environmental factors and genotype-phenotype correlations is needed to improve screening and tailored treatment strategies. Addressing these challenges is crucial for mitigating the evolving burden of celiac disease across diverse Indian populations. Conclusion: This review aimed to analyse the pathophysiology and prevalence of celiac disease among the Indian population, emphasizing regional variations, genetic predisposition, dietary influences, and diagnostic challenges. Celiac disease represents an emerging public health issue in India, necessitating increased awareness among healthcare professionals and the general population. Standardised diagnostic protocols, population-based screening, and improved accessibility to gluten-free foods are essential for early detection and effective management. Future research should focus on regional epidemiology and the interplay between genetics and dietary habits to inform tailored preventive strategies.