Medical Laboratory Science (MLS) is a vital component of the health care system that provides diagnostic services and contributes to medical research. In India, MLS has been evolving rapidly in terms of technology, education, regulation, and quality. This paper aims to provide a comprehensive overview of the current status and future prospects of MLS in India, with a focus on the challenges and opportunities faced by the professionals and stakeholders involved in this field. The historical development and scope of MLS in India is described, highlighting the various roles and responsibilities of MLS professionals in different settings. Further, the current trends and innovations in MLS, such as molecular diagnostics, point-of-care testing, automation, and role of artificial intelligence are discussed. The major challenges and gaps are highlighted that need to be addressed to improve the quality, accessibility, affordability, and sustainability of MLS services and infrastructure in India, such as the lack of standardization, regulation, accreditation, recognition, training, and research. Moreover, the opportunities and initiatives that can enhance the capacity and contribution of MLS services in India are mentioned, such as the adoption of new technologies, innovations, and best practices; the strengthening of human resources, education, and collaboration; the development of ethical and legal frameworks; and the creation of an enabling environment for MLS innovation and adoption. The paper intends to provide a comprehensive overview of the emerging landscape of MLS in India and to inspire further research and discussion on this topic.