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Introduction: Nasya Karma, one of the Panchakarma procedures in Ayurveda, involves the administration of herbal oils, juices, or powders through the nasal route. Classical texts describe the nose as the gateway to the head (Nasa hi Shiraso Dwaram), highlighting its therapeutic potential in diseases of the central nervous system and ENT disorders. Methods: A comprehensive narrative review was conducted using Ayurvedic classics (Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya), standard commentaries, and contemporary biomedical literature. Databases including PubMed, Scopus, Web of Science, AYUSH Research Portal, and Google Scholar were searched with terms such as “Nasya Karma,” “Ayurveda nasal therapy,” “intranasal drug delivery,” and “neurological disorders Ayurveda.” Inclusion criteria comprised clinical trials, experimental studies, and reviews published from 2000–2024. Results: Classical references classify Nasya into Virechana Nasya (eliminative), Brimhana Nasya (nutritive), Shamana Nasya (palliative), and Marshya/Pratimarshya Nasya (daily preventive use). Diseases such as migraine, sinusitis, cervical spondylosis, epilepsy, paralysis, hoarseness of voice, rhinitis, and optic disorders are indicated. Modern pharmacological studies suggest that intranasal administration bypasses the blood–brain barrier, enabling rapid CNS action. Clinical studies report significant improvement in migraine, allergic rhinitis, cervical spondylosis, and neurodegenerative conditions like Parkinson’s disease. Discussion: The classical rationale of Nasya aligns with modern intranasal drug delivery systems. It not only facilitates local action in ENT disorders but also exerts systemic effects in neurological conditions. Limitations include variability in formulations, lack of standardization, and limited large-scale randomized trials. Conclusion: Nasya Karma represents a promising integrative therapy for neurological and ENT disorders. With standardization and rigorous research, it has the potential to contribute significantly to global health care as a safe, effective, and non-invasive therapeutic approach.

KEYWORDS: Ayurveda, Intranasal therapy, Nasya Karma, Neurological disorders, Panchakarma