Riding on brilliant performances by Bismah Maroof (68 not out off 55) and Ayesha Naseem (43 not out off 25), Pakistan posted a competitive total of 149-4 in stipulated 20 overs.
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Chasing 150, Shafali Verma was partnered by Yastika Bhatia for India at the top with Smriti Mandhana out injured. The duo put on 38 for the opening wicket before Yastike was dismissed by Sadia Iqbal in the final over of the Powerplay.
Verma and Jemimah Rodrigues rebuilt, but Pakistan struck in the 10th over when Sidra Amin pulled off a stunning catch close to the ropes to send back Verma. While Harmanpreet Kaur and Jemimah fought back for a bit, Nashra Sandhu sent back Kaur in the 14th over to give Pakistan a massive boost.
But, Jemimah Rodrigues led India's fight in the run chase by smashing a fine unbeaten fifty (53 not out off 38) and along with Richa Ghosh (31 not out off 20), took India over the victory line in 19 overs with seven wickets in hand.
Earlier, Pakistan, who won the toss and opted to bat first, lost opener Javeria Khan to Deepti Sharma in the second over.
Bismah Maroof and Muneeba Ali took the attack to Deepti to help Pakistan to 39/1 at the end of the Powerplay, their highest against India in the first six overs in women's T20Is.
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However, Radha Yadav struck soon after with the wicket of Muneeba and Pooja Vastrakar sent back Nida Dar for a duck to put India back on top. The in-form Sidra Amin joined Maroof in the middle and the duo put on 25 for the fourth wicket before a freak dismissal saw Amin dismissed by Radha.
Ayesha Naseem's entry added impetus to Pakistan's innings as she raced off the blocks with some lusty blows. Maroof held one end up as Ayesha charged from the other to lift Pakistan past the 100-run mark in the 16th over.
Maroof completed her fifty soon after as the duo put on a partnership that pushed India onto the back foot. The unbeaten 81-run stand helped Pakistan to 149/4 at the end of 20 overs. The last five overs yielded 58 runs as Pakistan gave India a stiff target.
Brief scores: Pakistan Women 149-4 in 20 Overs (Bismah Maroof 68 not out, Ayesha Naseem 43 not out; Radha Yadav 2/21) lost to India Women 151-3 in 19 Overs (Jemimah Rodrigues 53 not out, Richa Ghosh 31 not out; Nashra Sandhu 2/15) by 7 wickets.