19 November 2015 Last updated at 07:52 GMT
Nearly half the population goes to the toilet in the open, and the prime minister has vowed to end the practice.
But even if toilets are available, women must pay to use them whereas men can urinate for free.
As part of the BBC's 100 Women season, on United Nations World Toilet Day, we spend a day with Mumtaz Shaikh, who is leading a 'right to pee' movement in Mumbai.
Safe sanitation is a huge issue in India, especially for women.