In most of Himalayan regions Sowa-Rigpa is practiced in traditional way with community support with an sMenpa in every village. But since the last two decades this scenario has been changing, adopting some of the administrative elements of modern hospital system in educational Institutions, dispensaries, hospitals and pharmacies etc. Nevertheless, still there are all together around 1000 practitioners of Sowa-Rigpa in India catering health care in harsh Himalayan regions and other places. Dharamshala in Himanchal Pardesh and Ladakh region of J&K are the main Centers for Sowa-Rigpa Institutions in India.
After taking refuge in India His Holiness the Dalai Lama has been in Dharamsala (Himachal Pardesh) where he has set up the Tibetan Medical and Astro. Institute to train the youngsters and provide quality health service through Sowa-Rigpa. This Institute has a Medical college, Pharmacy, Astrology section and a chain of 40-50 clinics all over India. There is Central Council for Tibetan Medicine in Dharamsala to regulate the practice of Sowa-Rigpa in India, it looks after the registration of practitioners, standard of colleges and other mechanism to regulate Sowa-Rigpa.