Pulmonary rehabilitation (PR) and chest physiotherapy are vital components in the management of chronic respiratory diseases, particularly in India, where the prevalence of conditions such as chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), asthma, and post-tuberculosis sequelae is rising. Pulmonary rehabilitation is a comprehensive, multidisciplinary intervention combining exercise training, education, and psychosocial support, aimed at improving patients' quality of life and reducing hospital admissions. Chest physiotherapy focuses on enhancing lung function and airway clearance through techniques like postural drainage, percussion, vibration, and breathing exercises. Despite the recognized benefits, these services remain underutilized in India, primarily due to a lack of awareness, limited infrastructure, and financial constraints. This review highlights the current state of PR and chest physiotherapy in India, comparing it with global practices, identifying the challenges to access, and offering strategies to expand and improve services, particularly in rural areas. Expanding home- based rehabilitation models and incorporating telemedicine could bridge the service gap, while strengthening healthcare provider training and policy integration may enhance accessibility and affordability.