Subclinical hypothyroidism (SCH) is the most prevalent thyroid disorder in the Indian population. Since the last publication of the 2015 Indian Thyroid Society guideline on SCH, many significant clinical and scientific advances have occurred in the field. The aim of this guideline is to inform clinicians, researchers, and health policymakers about published evidence related to the diagnosis and management of SCH in adults. The specific clinical questions addressed in this consensus are based on the inputs from the task force of experts in the field of endocrinology and thyroid disease. The consensus statements are derived based on the latest published articles and evidence in SCH. A well-defined grading system has been followed for the critical appraisal of evidence and grading strength of recommendations. The guideline includes recommendations on the prevalence, causes, consequences, screening, diagnosis, and treatment of SCH. Other aspects detailed are the role of levothyroxine, its impact on the timing of treatment, and its benefits on various SCH consequences and populations. Therefore, these evidence-based recommendations are developed to inform clinical decision-making in the management of SCH in adults. While in some cases individualization of treatment is a necessity, these recommendations can provide standards of optimal care for patients with SCH.