The growing focus on palliative care for terminally ill patients, such as those with advanced cancer and AIDS, has intensified the debate over euthanasia, or ‘mercy killing’. This issue is increasingly relevant as both developed and developing countries, including India, see rising numbers of severely ill patients facing complex medical, emotional, and existential challenges. The legal and moral aspects of euthanasia remain controversial in India highlighting the need for a detailed examination of this topic. This review explores euthanasia from historical, legal, cultural, and clinical perspectives, emphasizing the significant regional variations in approach and the ethical, legal, and medical issues involved. Socio-cultural and legal factors further complicate the debate in India, leading to growing support for passive euthanasia despite existing restrictions. The review also considers the unique challenges of euthanasia in psychiatric conditions, underscoring the importance of stringent criteria and comprehensive evaluations.