There are multiple social, economic, cultural and religious factors that affect the adherence of Indian pregnant women and women of childbearing age to diet- and exercise-based lifestyle interventions. A systematic summary of qualitative evidence to identify these determinants is not available in literature. So, we aimed to systematically review and synthesize the qualitative evidence regarding various determinants of adherence to lifestyle interventions among pregnant women and women of childbearing age in India. In this qualitative systematic review, we searched MEDLINE, Embase and Psych INFO (from inception till June 2022) for qualitative studies on barriers, facilitators, views, perceptions, experiences, myths and misconceptions towards diet- and exercise-based lifestyle behavior change among pregnant women and women of childbearing age in India. We performed thematic synthesis to identify themes and to identify potential determinants. We identified 512 articles from the database search. After title and abstract screening, 42 studies entered full-text screening. After full text screening, 15 studies were included for the final analysis. The following themes were most prevalent in the published studies: 1)Myths and beliefs about ingestion of ‘hot and cold’ foods during pregnancy, 2)Maternal malnutrition in the low resource setting, 3)Culturally acquired practice of fasting (such as Ramadan) during pregnancy, 4)Cultural beliefs that fruits are harmful to the foetus resulting in very low fruits intake, 5)Absence of care seeking behavior with respect to mental health as they were considered ‘personal’, 6)‘walking’ was considered the most feasible but lack of motivation and time, stray dogs and narrow roads were highlighted barriers and, 7)Use of traditional dietary medicines named ‘country medicine’. Our review highlights that the key barriers and facilitators for lifestyle interventions during pregnancy and childbearing age are lack of knowledge on maternal nutrition, cultural myths and wrong beliefs of diet and physical activity during pregnancy, lack of motivation to exercise and lack of care seeking for mental healthcare. Qualitative evidence on lifestyle determinants is sparse, highlighting the critical research gap in India. Nevertheless, this review highlights the determinants of adherence to lifestyle intervention in Indian women. Addressing these could potentially improve the adherence to diet and lifestyle interventions for this population.