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Introduction: Uterine fibroids, or leiomyomas, are benign smooth muscle tumors of the uterus, commonly affecting women of reproductive age. They present with menorrhagia, dysmenorrhea, pelvic pain, and infertility. Conventional management includes hormonal therapy, myomectomy, or hysterectomy, which may lead to recurrence or complications. Ayurveda correlates uterine fibroids with Yonivyapad, resulting from dosha imbalance (Vata-Kapha), Rakta vitiation, and obstruction of the Artavavaha Srotas. Herbal therapy, Panchakarma procedures, and lifestyle modifications are traditionally recommended to restore dosha balance and uterine health. Methods: A systematic literature review was performed using PubMed, Scopus, Web of Science, Google Scholar, and AYUSH Research Portal. Keywords included “uterine fibroids,” “leiomyoma,” “Yonivyapad,” “Ayurveda,” “herbal therapy,” and “Panchakarma.” Classical Ayurvedic texts, preclinical studies, clinical trials, and systematic reviews published between 2000–2025 were included. Exclusion criteria encompassed non-peer-reviewed articles and studies lacking clinical outcomes. Data were synthesized thematically based on pathophysiology, symptomatology, and management strategies. Results: Ayurvedic management of uterine fibroids emphasizes dosha balancing, Rakta purification, and uterine tonicity. Panchakarma interventions such as Virechana (therapeutic purgation) and Basti (medicated enema) target vitiated Vata and Kapha, alleviating pelvic congestion and pain. Herbal formulations including Ashokarishta, Dashamoola, Shatavari, Punarnava, and Guggulu demonstrate anti-inflammatory, analgesic, and hormonal modulatory properties. Clinical studies report reduced fibroid size, improved menstrual patterns, decreased pain, and enhanced fertility outcomes with minimal adverse effects. Discussion: Ayurvedic management complements modern therapy by addressing etiological factors and systemic imbalance, rather than only symptoms. Although preliminary evidence supports its efficacy, limitations include small sample sizes, heterogeneity in formulations, and lack of standardized protocols. Future studies should focus on randomized controlled trials, mechanistic evaluation, and integrative approaches. Conclusion:  Ayurvedic therapies for uterine fibroids offer a holistic approach to symptom relief, dosha balance, and reproductive health. Integration with conventional management may improve clinical outcomes and reduce recurrence, supporting a patient-centered, evidence-based framework for gynecological care.

KEYWORDS: Ayurveda, fibroids, herbal therapy, Panchakarma, Yonivyapad