Substance abuse has been a global public health concern for decades. Various social, psychological, and health risks of substance abuse have been studied in detail. The objective of this narrative review is to understand and discuss the rising issue of substance abuse among adolescents in India and the measures to tackle this issue. A proper literature search and analysis, along with expert interviews, were conducted to understand the topic. The results showed a growing concern for various substances in Indian adolescents, especially alcohol, smoking, cannabis, and other synthetic products. Various factors, like genetics, family history, cultural factors, peer influence, and work culture, influence substance abuse in adolescents. Strict policy-making, the involvement of educational institutions, family counseling, and health system involvement are key to controlling this issue.