India's Jemimah Rodrigues was ruled out of the fourth T20I against Sri Lanka due to illness, confirmed by captain Harmanpreet Kaur. India, already leading the series 3-0, made two changes to their playing XI, including Harleen Deol replacing Rodrigues and Arundhati Reddy coming in for the rested Kranti Gaud. Sri Lanka also made changes, opting to bowl first in pursuit of their first win.