The strongest Indian summer monsoon (ISM) on the planet features prolonged clustered spells of wet and dry conditions often lasting for two to three weeks, known as active and break monsoons. The active and break monsoons are attributed to a quasi-periodic intraseasonal oscillation (ISO), which is an extremely important form of the ISM variability bridging weather and climate variation. The ISO over India is part of the ISO in global tropics. The latter is one of the most important meteorological phenomena discovered during the 20th century (Madden & Julian, 1971, 1972). The extreme dry and wet events are regulated by the boreal summer ISO (BSISO). The BSISO over Indian monsoon region consists of northward propagating 30–60 day and westward propagating 10–20 day modes. The “clustering” of synoptic activity was separately modulated by both the 30–60 day and 10–20 day BSISO modes in approximately equal amounts. The clustering is particularly strong when the enhancement effect from both modes acts in concert. The northward propagation of BSISO is primarily originated from the easterly vertical shear (increasing easterly winds with height) of the monsoon flows, which by interacting with the BSISO convective system can generate boundary layer convergence to the north of the convective system that promotes its northward movement. The BSISO-ocean interaction through wind-evaporation feedback and cloud-radiation feedback can also contribute to the northward propagation of BSISO from the equator. The 10–20 day oscillation is primarily produced by convectively coupled Rossby waves modified by the monsoon mean flows. Using coupled general circulation models (GCMs) for ISO prediction is an important advance in subseasonal forecasts. The major modes of ISO over Indian monsoon region are potentially predictable up to 40–45 days as estimated by multiple GCM ensemble hindcast experiments. The current dynamical models’ prediction skills for the large initial amplitude cases are approximately 20–25 days, but the prediction of developing BSISO disturbance is much more difficult than the prediction of the mature BSISO disturbances. This article provides a synthesis of our current knowledge on the observed spatial and temporal structure of the ISO over India and the important physical processes through which the BSISO regulates the ISM active-break cycles and severe weather events. Our present capability and shortcomings in simulating and predicting the monsoon ISO and outstanding issues are also discussed.