The Indian government aspires to have fifty colleges and universities ranked among the top one thousand in the world. Alternatively, the National Institutional Ranking Framework (NIRF) was established to evaluate and rank Indian universities according to national criteria for accessible and inclusive education, with the overarching goal of achieving global leadership in this area. The study aims to investigate the factors that influence NIRF rankings and identify the specific areas where Punjab medical colleges and universities are lagging behind. It will explore strategies to improve their performance and achieve higher rankings on the NIRF list. The study used secondary sources, such as journal articles, to collect primary data on NIRF rankings and citations from reputable sources like The Gazette of India. Qualitative findings were analyzed through peer review and a comprehensive literature review. This combination of secondary data analysis and critical evaluations provided a strong foundation for understanding the topic and thoroughly examining the findings. The NIRF is the primary authority for evaluating universities. Punjab's medical institutions are hindered by the government's neglect of TLR&RP. Increased funding, active participation, and addressing deficiencies in healthcare, education, and research are crucial for improving rankings and achieving long-term success.