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Background: Recurrent pregnancy loss affects a small but significant proportion of couples, and in about half of them no cause is found. Conventional management of unexplained recurrent loss relies on supportive care and, in selected women, progesterone, while many empirical treatments lack evidence. Ayurveda describes repeated foetal loss under Garbhasrava, Garbhapata and Putraghni yonivyapad, and recommends Garbhasthapaka (pregnancy-sustaining) drugs and medicated ghee preparations such as Phala ghrita for women with a history of loss. Objective: To review the classical Ayurvedic concepts of recurrent pregnancy loss, the Garbhasthapaka group of drugs and Phala ghrita, to place them against current biomedical guidance, and to summarise the published evidence for their use. Methods: Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya and Bhaishajya Ratnavali were reviewed for descriptions of foetal loss and its prevention. PubMed was searched up to October 2026 for guidelines, systematic reviews, trials, protocols and case reports on recurrent miscarriage, progestogens, Ayurvedic interventions in pregnancy and infertility, Phala ghrita and safety of herbal products in pregnancy. Findings were synthesised narratively. Results: Classical texts describe a coherent preventive approach comprising preconception purification, Garbhasthapaka drugs, medicated ghee and a month-wise antenatal regimen. Biomedical guidelines confirm that most recurrent loss is unexplained and that progesterone offers at best modest benefit in women with prior losses. Published evidence for Phala ghrita consists of one early uncontrolled study, case reports and a registered trial protocol in infertility; no controlled study of Garbhasthapaka drugs or Phala ghrita in recurrent pregnancy loss was found. Safety concerns include heavy-metal contamination of some Ayurvedic products and limited data on herbal exposure in early pregnancy. Conclusion: Garbhasthapaka drugs and Phala ghrita are biologically plausible adjuncts for preconception and early-pregnancy care but remain unproven for recurrent pregnancy loss. They should complement, not replace, guideline-based investigation, and require quality-assured products and controlled trials.