<p>Theranostics, a combination of therapeutic and diagnostic approaches using molecular imaging and targeted radionuclide therapy, represents a significant advancement in personalized medicine. The Indian subcontinent, with its vast and diverse population, presents a unique landscape for the development and implementation of theranostics. This review critically examines the opportunities, challenges, and future directions of theranostics in the region. The large patient burden provides a fertile ground for research and clinical applications. Additionally, the presence of skilled manpower and established infrastructure offers a solid foundation for its advancement. However, financial constraints, uneven geographical distribution of expertise, and manpower shortages pose significant hurdles. This paper discusses strategies to address these challenges, emphasizing policy interventions, capacity building, and research initiatives to ensure equitable and sustainable growth of theranostics in the Indian subcontinent.</p>