This document analyzes the causes and effects of cost overruns in construction projects in India. It identifies major reasons for cost overruns such as inaccurate planning, delays in land acquisition, weather issues, shortage of skilled labor, and contractor inefficiencies. The author conducted a case study of a hospital construction project in Pune to identify specific overrun factors like delayed payments, poor scheduling, and ineffective management. The conclusion is that the most significant overrun causes are delayed payments, inaccurate planning, weather, lack of experienced staff, excessive contractor workloads, and poor liquidity/management. Recommendations to avoid overruns include proper planning, accounting for cost variations, clear project scoping, efficient resource use, and strong communication.