The rapid proliferation of e pharmacies in India has outpaced the evolution of the legal framework governing the sale and distribution of medicines. This article examines the fragmented and outdated regulatory landscape, which relies on colonial era statutes such as the Drugs and Cosmetics Act, 1940, and the Pharmacy Act, 1948—enactments that never contemplated digital commerce. Despite the publication of the Draft E Pharmacy Rules in 2018, the rules remain unenforced after more than eight years, leaving e pharmacies to operate in a legal grey zone. The article analyses the conflicting interpretations of “intermediary” status under the Information Technology Act, 2000, as illuminated by the landmark Delhi High Court ruling in IndiaMART v. CDSCO (2025), and contrasts this with the accountability obligations imposed by the Consumer Protection (E Commerce) Rules, 2020. Emerging challenges are scrutinised, including the entry of quick commerce platforms into medicine delivery, the “order and approve” telemedicine scandal involving Blinkit, the systemic failure of India’s QR code based drug authentication system exposed by counterfeit Levipil 500, and the consumer compensation ruling from the Pune District Commission. The article also evaluates the Jan Vishwas Act amendments, the stalled GSR 817(E) and GSR 220(E), and the proposed Drugs, Medical Devices and Cosmetics Bill, 2025, as potential pathways toward a coherent regulatory framework. It concludes that the current regulatory vacuum poses serious risks to patient safety—ranging from antimicrobial resistance due to unsupervised antibiotic sales to the circulation of counterfeit drugs—and argues for urgent legislative action to establish a technology neutral, risk based licensing regime that balances innovation with robust consumer protection and professional ethical standards.