In the recent years, there has been a radical shift from a ‘one drug fits all’ conventional approach to a personalized patient orientated approach. Pharmacogenomics (PGx), an integral part of Personalized Medicine (PM), is the analysis of how genetic factors can influence drug responses.72 It considers the needs of each patient and provides customized therapeutic approaches.47 While this scientific area originally focused on the correlation between drugs and single genes (pharmacogenetics), pharmacogenomics at present, subsumes information from the entire genome inclusive of germ line variation (single nucleotide polymorphisms (SNPs), gene copy number alterations) and acquired alterations (tumor mutations) as they associate with drug response or toxicity.57 The potential of genomic evaluation as a fundamental element of Personalized Medicine is rapidly becoming a reality in many nations across the globe.60 This article is all about the comprehensive review of the various advances in the field of personalized medicine with Pharmacogenomics at its cornerstone. It includes studies on identification of novel biomarkers, therapies based on the genetic profile of individual patients, better prognosis of chronic diseases like diabetes, TB, cardiovascular disorders, neoplasm’s and pulmonary diseases, to detect a genetic predisposition to adverse drug reaction (ADR), to predict the susceptibility to disease onset among populations for attaining maximum efficacy and minimal toxicity, with the goal of improving the overall patient experience and reduction in health-care costs. Accordingly, utilizing large empirical data, bibliography, with authentic unstructured treatment designs, we extensively analyzed review on the Pharmacogenomic evidence, in several randomized, prospective, observational and multicenter studies and its association with Precision Medicine.