Antimicrobial resistance (AMR) has become a major public health challenge, driven largely by the inappropriate and excessive use of antibiotics in healthcare settings. Antibiotic stewardship (AS) comprises coordinated interventions that promote the appropriate selection, dosage, route, and duration of antimicrobial therapy to improve patient outcomes while minimizing the emergence of drug-resistant pathogens. Effective stewardship strategies include pre-prescription authorization, post-prescription review with feedback, evidence-based antibiotic selection, and de-escalation of therapy based on clinical response and microbiological findings. AS also emphasizes the rational use of dosage formulations, adherence to prescribed treatment courses, and optimization of therapy to reduce unnecessary antimicrobial exposure. In India, stewardship programs are increasingly being implemented in tertiary care hospitals through structured initiation and expansion phases, supported by standardized monitoring and clinical outcome assessment. However, implementation remains limited in many primary and secondary healthcare facilities. Strengthening antibiotic stewardship across all levels of healthcare, together with the adoption of Indian Council of Medical Research (ICMR) Standard Treatment Workflows, is essential for preserving antibiotic effectiveness, improving patient care, and combating antimicrobial resistance.