Aims and background: The increasing prevalence of cannabis consumption necessitates a comprehensive examination of its impact on health and associated risks. Materials and methods: The pattern of cannabis use and incidence of cannabis abuse (CA) dependence among the 1,914 cannabis user population was investigated from randomly selected wards of Bikaner city (Northwest Rajasthan), where an epidemiological survey was conducted to assess the prevalence of cannabis abusers with psychiatric and cognitive manifestations. All users were screened and analyzed clinically. The brief psychiatric rating scale (BPRS), cannabis experienced questionnaire (cannabis consumption frequency and form of dose), and neurocognitive battery were used for detecting any cognitive impairment. Results: Cannabis use was reported by 1,914 out of 17,545 populations of 20 surveyed wards in Bikaner city, with a prevalence of 10.91%. Current CA (74.45%), compared with past cannabis users (25.55%), shows highly significant values due to current users’ intake of heavy cannabis routinely. Psychiatric problems such as anxiety, depression, schizophrenia, mixed anxiety-depression disorder, and psychotic disorder show a significant correlation with the cannabis abuser population (p < 0.001). Apart from psychiatric manifestations, 12.12% of cannabis abusers have neurocognitive impairment. Conclusion: The high prevalence and regular usage of cannabis among the general population of Bikaner city suggest the need for assessing its prevalence in other regions with similar or dissimilar geographical and cultural characteristics. Clinical significance: While cannabis use has traditionally been considered harmless, the findings of associated psychiatric and neurocognitive impairments indicate a different narrative. The easy accessibility of cannabis, particularly among the young, is concerning and necessitates immediate action.