The Covid-19 pandemic accelerated the deployment of digital health technologies for surveillance, contact tracing, and service delivery in India. While these tools support public health responses, they raise significant ethical, legal, and social concerns. Existing evidence remains fragmented and largely descriptive, with limited synthesis in the Indian context. This review is innovative in providing an India-specific, domain-based synthesis of ethical issues and linking pandemic-era experiences with post-Covid regulatory and system developments, including the Digital Personal Data Protection Act, 2023, the Ayushman Bharat Digital Mission, and Electronic Health Records, to inform future digital health governance. This systematic review aimed to examine the ethical issues associated with digital health data collection and surveillance during the Covid-19 pandemic in India.

A systematic search of PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar was conducted for studies published between January 2020 and October 2024. Eligible studies addressing the ethical aspects of digital health technologies used during Covid-19 in India were included. Data were synthesized narratively and organized using a domain-based framework.

Nine studies met the inclusion criteria. Ethical concerns were consistently reported across five core domains: privacy, consent, governance, equity, and trust issues. Common issues include unclear consent mechanisms, data protection risks, limited transparency, digital exclusion, and erosion of public trust. The evidence spanned multiple digital health applications, including contact-tracing tools, telemedicine platforms, mHealth systems, and public data dashboards.

Ethical challenges identified during the Covid-19 pandemic should inform the design and implementation of current and future digital health systems. Integrating these lessons into emerging regulatory and digital health frameworks is essential to ensure ethical, secure, and equitable public health in India.