The prevalence of youth-onset type 2 diabetes is increasing worldwide in parallel with the obesity epidemic. In India, the age at onset of type 2 diabetes had traditionally been a decade or two earlier compared with the western population. Hence, it is not surprising that the prevalence of youth-onset type 2 diabetes is rapidly escalating in India not only among the more affluent sections of society but also in the middle and lower socioeconomic groups as well. In India, type 2 diabetes in youth overlaps with monogenic forms of diabetes such as maturity-onset diabetes of the young, fibrocalculous pancreatic diabetes, and malnutrition-modulated diabetes, all of which are ketosis-resistant forms of youth-onset diabetes. Screening of high-risk groups may help in the early detection of youth-onset type 2 diabetes and prevention of its complications. Primary prevention would require a multisectoral approach involving the government and non-governmental agencies with a focus on healthier lifestyles among children.