The Madukkarai Government Hospital, a taluk-level facility in Coimbatore district, operates from approximately 80 cents and faces severe space crunch. The hospital has 60 beds and serves 550 to 600 outpatient cases daily, often reaching maximum occupancy. It provides round-the-clock services in obstetrics and gynaecology, paediatrics, and surgery, plus outpatient and casualty wards. The hospital's location near the Kochi-Salem national highway enables it to manage emergency and accident cases from surrounding regions and border areas. The Coimbatore District Health Department has requested 30 cents of vacant land from the neighbouring government veterinary hospital (Animal Husbandry Department) to expand facilities. The department has sent two letters to district administration but no action has been taken. District Collector Pawan Kumar G Giriyappanavar stated the hospital plays a significant role in public health and said he would look into obtaining consent from the relevant department owning the required land.

Traffic congestion on Palakkad Road worsening as Madukkarai-Marappalam railway underpass expansion work delayed over one year. Palakkad Railway Division completed nearly 50% of railway portion. State highways department road expansion facing setbacks due to land acquisition and tender process.

Project began May 2025, aims to replace narrow British-era structure with modern facility. Involves dismantling old bridge, installing new rectangular precast RCC box for railway track, widening road for approximately 750 metres including 89 metres within underpass.

Design: four-lane main carriageway 16.2 metres, 5.5 metre service roads on both sides, 1.5 metre footpaths and drainage.

Tender for road works called off; scrutiny of 14 bidders under way. Tender evaluation to complete within 30 days. Once awarded, work will take around 18 months.

Department plans to acquire 4,300 square metres of land for service roads and drainage. Notification under Section 15(2) Tamil Nadu Highways Act to be issued after negotiation with landowners.

Light vehicles and buses diverted via Quarry Office Road, Kurumbapalayam Road and Madukkarai Market Road to Chettipalayam. Heavy vehicles advised to take Athupalam-Kurichi-Eachanari route to reach Salem-Kochi highway. Diversions causing severe peak-hour congestion with Kerala-bound vehicles waiting in long queues, with reports of one-hour waits at Madukkarai Market during peak hours.

Coimbatore’s manufacturing, education and healthcare sectors are expanding, but congestion affects Avinashi, Trichy, Sathy, Mettupalayam, Pollachi and Thadagam roads. The West Bypass is planned from Mylkal to Narasimpalayam; only its first phase, from Mylkal to Mathampatti, is operational, with no sign of phases two and three. The government has abandoned the East Bypass planned from Madukkarai to Periyanaickenpalayam. The 10-km G.D. Naidu Flyover is operational, but its announced 5-km extension to Neelambur has stalled. Plans for the old Avinashi Road flyover, and flyovers at Singanallur, Lala Road, Sundarapuram and Saravanampatti, have not advanced. The L&B Bypass six-lane expansion remains at the study stage, as does the Uppilipalayam roundabout upgrade. The Centre returned Tamil Nadu’s Coimbatore Metro proposal twice. The Vellalore integrated bus terminal has made no progress. NITI Aayog has approved the airport expansion after a decade of delay. Industry representatives warn inadequate infrastructure could deter investment; Singanallur and Sundarapuram flyovers remain under study.

Coimbatore’s 32.43-km, four-lane Western Ring Road will connect Mylkal on Salem-Cochin Road (SHU 52) to Narasimhanaickenpalayam on Nagapattinam-Gudalur-Mysore Road (NH 67), passing through 15 revenue villages. Planned in three phases, Phase I covers 11.80 km through Madukkarai, Sundakkamuthur, Perur Chettipalayam, Theethipalayam and Madampatti. Launched in August 2023, it was completed in February 2026 at an estimated cost of ₹250 crore and inaugurated by former Chief Minister MK Stalin on March 13. Its 800-metre Mylkal flyover, intended to ease congestion at the Palakkad Main Road junction, remains under 25% complete despite work starting in May 2025; only two deck slabs have been built. Underground water and drainage pipelines required relocation, while rocky terrain delayed excavation and foundations. Basement work has begun on one side, and officials aim to finish within four months. Phase II covers 12.10 km through Perur, West Chithirai Chavadi, Kallikanaicken Palayam, Vadavalli and Somayampalayam. Tenders and projects announced by the previous DMK administration are suspended for review by the TVK government; it will decide when Phase II begins.

Traffic diversions came into effect to facilitate expansion of Marappalam railway underpass at Madukkarai from one lane to four lanes.

Coimbatore to Palakkad (town buses and light motor vehicles): Left turn at Madukkarai junction via Quarry Office road, Kurumbapalayam road, Madukkarai market road to Chettipalayam junction.

Palakkad to Coimbatore (town buses and light motor vehicles): Right turn at Chettipalayam junction via Virakukadai Palam and ACC cement factory road.

City to Palakkad (trucks and heavy vehicles): Via Athupalam junction, Kurichi and Eachanari road to Salem–Kochi highway. Reverse direction uses same route.

Schools and college buses from Athupalam and Sundarapuram junctions towards Palakkad road: Via Kurichi–Kannamanaickanur road, then left turn to Salem–Kochi highway. Same route from Palakkad Road to city.

SETC, TNSTC and KSRTC buses Coimbatore to Palakkad: Via Kurichi–Kannamanaickanur road, Madukkarai Market road and Chettipalayam junction to Salem-Kochi highway. Reverse direction uses same route.