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Introduction: Reproductive health is influenced by multiple factors, including diet and lifestyle. Ayurveda describes Pathya-Apathya (wholesome and unwholesome diet and regimen) as essential determinants of Shukra dhatu (reproductive tissue) and fertility. Understanding these traditional guidelines in the context of modern reproductive health may provide holistic preventive and therapeutic strategies. Methods: A systematic review of Ayurvedic classics (Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya, Kashyapa Samhita) and their commentaries was performed to identify references to Pathya-Apathya related to fertility and reproductive health. A comprehensive literature search was carried out in PubMed, Scopus, Web of Science, and Google Scholar (2000–2025) using terms “Ayurveda and reproduction,” “Pathya-Apathya,” “diet and fertility,” and “lifestyle and reproductive health.” Clinical trials, observational studies, and review articles were included, while irrelevant or anecdotal sources were excluded. Results: Ayurvedic texts emphasize Pathya—nutritious, easily digestible, unctuous foods such as milk, ghee, fruits, and shukra-vardhaka herbs—and lifestyle practices including adequate sleep, stress management, and sexual discipline. Apathya includes excessive alcohol, processed foods, irregular sleep, overexertion, and psychological stress, all of which are said to vitiate Vata and impair fertility. Modern research supports these insights: balanced diet, micronutrient sufficiency, healthy BMI, and lifestyle modifications correlate with improved ovulation, sperm quality, and reproductive outcomes. Unhealthy lifestyle factors (e.g., smoking, obesity, stress) are linked to infertility and adverse pregnancy outcomes. Discussion: Ayurveda’s Pathya-Apathya principles parallel modern evidence on nutrition, exercise, and stress management in reproductive health. However, robust clinical validation is limited, necessitating integrative research. Conclusion: Pathya-Apathya offers a holistic framework for optimizing reproductive health. Integrating Ayurvedic wisdom with modern biomedical strategies may enhance fertility care and preventive reproductive health.

KEYWORDS: Ayurveda, Fertility, Lifestyle, Nutrition, Reproductive health.