The COVID-19 pandemic, from its beginning in India on 30 January 2020, has caused over 3.7 million cases of illness and claimed over 66 thousand deaths as of 1 September2020. The large metropolitan cities have been the major hotspots of COVID-19 pandemic. The peculiar urbanisation patterns are crucial in spreading COVID-19 in India. This study attempts to highlight how urbanisation patterns increase the vulnerability of COVID-19 spread in India. The higher density, urban sprawl and associated intra-urban commuting, large slum population, inadequate water, sanitation and housing conditions along with homelessness are found to catalyse the vulnerability of COVID-19 spread in urban areas. The existing public health infrastructure in the country is found to be inadequate with respect to the increasing demand. Efforts to contain the spread are being made; nonetheless, the rapid increase in the cases of illness and deaths from COVID-19 has inflated the challenges for administration and citizens. Rapid enhancement in health infrastructure and health personnel must be made along with strict adherence to the measures of quarantine, social distancing and hygiene for the citizens are of utmost response to the decrease the spread.