Among the major health transitions witnessed in the second half of the twentieth century, the most globally pervasive change has been the rising burden of non-communicable diseases (NCDs). This has given rise to new challenges of providing acute and chronic care for NCDs, especially in poor countries such as India with an already existing mismatch between health care needs and resources. This paper examines the socio-economic impact and burden of NCDs and discusses various strategies for the prevention and control of such diseases in India. It recommends that existing health systems will need to be reorganized and reoriented to include the prevention, surveillance, and management of NCDs. The paper also recommends that evidence based clinical practice and appropriate use of technologies should be promoted at all levels of health care, including tertiary services.