The 2024 Declaration of Helsinki (DoH) marks a significant milestone in medical research ethics, addressing contemporary challenges and emphasising global ethical issues. In India, the 2017 Indian Council of Medical Research (ICMR) National Ethical Guidelines, align well with the 2024 DoH principles, particularly in safeguarding vulnerable populations and promoting ethical review processes. However, there is scope to work on further harmonisation and better implementation, such as registering all medical research, empowering ethics committees, and ensuring equitable access and inclusion. This perspective highlights the strengths and limitations of the ICMR guidelines in light of the 2024 DoH, aiming to foster a research environment that upholds ethical integrity, inclusivity, and the well-being of all participants.