Objectives: This review looks at how United State Food and Drug Administration (USFDA) Form 483 observations are linked to warning letters, especially for Indian pharmaceutical companies. Methodology: The study focuses on drug manufacturers and uses data from inspections and warning letters between January 2023 and November 2024. It also compares some older data from 2018 to 2020 to see changes over time. The researcher studied several sources, including regulatory guidelines like USFDA, World Heald Organization (WHO), and European Union good manufacturing practices (EU GMP), to understand current good manufacturing practices (cGMP) and why companies fail to meet them. Results: The findings show that if company gets a Form 483 during an inspection, there is a more than 50% chance it may get warning letter later, especially if the company has failed to reply properly. Over the past two years, 20 Indian companies obtained letters. Out of these, 10 already had 483 observations earlier, while others failed their first inspection due to serious good manufacturing practices (GMP) problems. The review concludes that many warning letters happen because of poor GMP compliance and weak follow-up after past inspections. Future research can help companies avoid such issues by improving quality systems. This can lead to better product safety and help companies save time and money