Freight traffic fulfils not only the business needs of a region to move goods between producers, manufacturers, and end consumers, but also creates a host of unintended environmental, social, and economic impacts. Despite its importance, freight traffic impacts and associated logistic inefficiencies are largely overlooked in the urban transport discussions in developing economies like India. This paper addresses this research gap by outlining the research progress related to freight transport in India and discusses the key problems related to freight system performance. The published literature in the last three decades (1990–2020), policy briefs and institutional reports are explored to summarize key findings and uncover thematic linkages. We categorize the inefficiencies in the freight system into four aspects: (i) long-haul trucking, (ii) last-mile logistics, (iii) freight distribution (inventory level), and (iv) policies and regulations. Apart from identifying the limitations in policy discourse, this paper also explores the possible solution concepts to improve efficiency in freight transport and mitigate the unintended negative externalities in urban areas. The overall conclusion is that increasing and improving infrastructure and equipment, technology and operations, and policy and regulations will go some way towards making freight more efficient in India and reducing congestion and emissions of air pollutants and GHG. The present paper can be expected to promote further freight research and effective policy instrument design in India.