Background: Huge investment has been made in improving health status of India. But still India has not achieved satisfactory results in terms of health outcomes. This calls for an assessment of the efficiency in health care system.

Objective: To conduct a critical review of the literature on efficiency measurement in health care in India

Methods: A comprehensive literature review was conducted to address the study objective.

Results: A total of eleven articles from different regions on India met the study inclusion criteria. All those studies which are based on health efficiency in terms of health outcomes in India both state wise and district wise are included. The studies found that relevant disparities are prevalent in India both state wise and district wise

Conclusion: The Body of literature gave a composite picture on the difference in the efficiency in health system performance in India both state wise and district wise. There is a need that government should frame health policy in such a way to reallocate resources from states which have abundant resources to those states that are efficient but poor in their health outcomes.