Dengue fever is a major public health issue in India because its incidence and mortality rates vary with environmental, social, and infrastructural factors. There are not many effective vaccines yet, so the main treatments are supportive care, vector control, and surveillance. This study aimed to examine patterns in dengue cases and deaths across Indian states from 2023-2025, focusing on regional differences, the effects of the COVID-19 pandemic and climate change, and the progress of vaccine development. Due to the COVID-19 pandemic, dengue cases in India remained a significant public health concern. In 2023, India reported 289,235 dengue cases and 485 deaths. In 2024, the number of reported cases declined to 233,519, with 297 deaths. As of 30 November 2025, 113,540 dengue cases and 95 deaths had been reported. Throughout this period, West Bengal, Maharashtra, Punjab, Uttar Pradesh, and Karnataka consistently recorded the highest dengue burden. Urbanization and climate change were two of the main reasons. There are still only a few vaccines to choose from, and it’s not clear how safe and effective the live-attenuated vaccines (Dengvaxia® and Qdenga). Dengue remains a growing and evolving threat in India. A comprehensive solution must encompass environmental management, vaccine research, public health monitoring, and climate change adaptation.