In India, female infertility constitutes a major public health problem, affecting millions of women who reside within diverse socio-economic, socio-cultural, and geographical environments. The current study reviews data available in the literature regarding epidemiology of female infertility in India, including prevalence, aetiology, incidence trends, and geographic variations. Rates of primary infertility range from 3.9% to 16.8%, depending upon the region in question, with secondary infertility making up a significant proportion of all infertile cases. Some of the main determinants of infertility among Indian females include polycystic ovary syndrome (PCOS), reproductive tract infection, tuberculosis, undernourishment, early marriages, delayed first pregnancy, and more recently developed causes, such as obesity. There is an observable variation in prevalence rate with respect to different geographic regions, being high among eastern and northeastern states of India due to their poverty levels, less medical care accessibility, and a higher burden of infectious diseases. Urban areas have been increasingly reporting cases of infertility related to delayed pregnancies and lifestyle issues, while those residing in rural areas are mainly affected by infectious causes and undernourishment. This review highlights the urgent need for region-specific, integrated public health interventions, improved surveillance systems, and equitable, culturally sensitive reproductive healthcare services to address the complex and evolving burden of female infertility in India.