Adolescence is a critical developmental stage characterized by rapid biological, cognitive, and psychosocial transitions. In the digital era, screen time has become an integral part of adolescent life, raising both opportunities and concerns. This review synthesizes global and India-specific evidence on the impact of screen exposure on adolescent development, health, and well-being. The article outlines a conceptual framework that classifies screen use into educational, recreational, social, and gaming domains, emphasizing the need to distinguish between passive and interactive engagement. Evidence suggests that while digital tools can enhance cognitive growth, digital literacy, and peer connectivity, excessive or unregulated use is associated with sleep disturbances, sedentary behavior, ocular strain, musculoskeletal problems, and mental health challenges such as anxiety, depression, and gaming disorder. Neurodevelopmental research further highlights alterations in attention and reward pathways linked to chronic exposure. The Indian context presents unique challenges and opportunities, shaped by an urban–rural digital divide, socioeconomic disparities, gender norms, and rapid technological penetration under initiatives like the Digital India Mission. Interventions must therefore be multidimensional—engaging families through digital parenting, schools through literacy programs, communities through awareness campaigns, and policymakers through regulations and infrastructure development. Technology-driven self-regulation tools also hold promise but require greater awareness and adoption. Current evidence gaps—particularly the lack of large-scale longitudinal studies and underrepresentation of rural populations—underscore the need for culturally tailored, multidisciplinary research. This review concludes that screen time is neither inherently harmful nor wholly beneficial; its impact depends on context, supervision, and balance. A coordinated effort among parents, educators, health professionals, and policymakers is essential to foster healthy digital engagement and safeguard the holistic development of India’s adolescents.