India's pharmaceutical industry, crucial for global medicine supply, faces significant reliability threats from climate change. Rising heatwaves, floods, and erratic rainfall jeopardize essential infrastructure like power, water, and cold chains, vital for drug manufacturing, storage, and transport. This imperils supply chain integrity and product quality, risking its "pharmacy of the world" reputation. The author emphasizes that climate adaptation is critical risk management, urging the industry to prioritize protecting facilities, securing resources, and strengthening logistics. Ignoring these escalating climatic disruptions could erode the fundamental trust on which India's pharmaceutical leadership depends.