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Introduction: Metabolic Syndrome (MetS) is a constellation of interrelated metabolic abnormalities, including central obesity, dyslipidemia, insulin resistance, and hypertension. It is a major risk factor for cardiovascular diseases and type 2 diabetes mellitus. Conventional medicine provides lifestyle modification and pharmacotherapy, yet challenges persist due to side effects, patient non-compliance, and lack of sustainable outcomes. Panchakarma, a cornerstone of Ayurveda, offers holistic detoxification and doshic balance, potentially addressing the root causes of metabolic imbalance. Methods: A systematic review was conducted using PubMed, Scopus, Web of Science, AYUSH Research Portal, and Google Scholar, alongside Ayurvedic classical texts. Studies published between 2000 and 2024 were analyzed. Clinical trials, experimental studies, reviews, and classical references pertaining to Panchakarma and metabolic disorders were included. Non-peer-reviewed and unrelated articles were excluded. Results: Panchakarma interventions such as Vamana (therapeutic emesis), Virechana (purgation), Basti (enema), Raktamokshana (bloodletting), and Nasya (nasal therapy) have demonstrated benefits in MetS. Clinical studies reveal improvements in lipid profiles, insulin sensitivity, body mass index, and blood pressure. Experimental evidence suggests that these therapies regulate gut microbiota, modulate inflammation, enhance detoxification, and restore Agni (digestive/metabolic fire). Virechana was found effective in dyslipidemia and hepatic dysfunction, Basti in insulin resistance and gut health, while Vamana reduced obesity and Kapha-related disorders. Discussion: Panchakarma aligns with modern concepts of systemic detoxification, metabolic resetting, and gut–brain axis modulation. However, heterogeneity in study designs, small sample sizes, and lack of biomarker-based endpoints limit generalizability. Conclusion: Panchakarma represents a promising integrative approach for MetS management, offering both preventive and therapeutic benefits. Future large-scale randomized controlled trials with standardized protocols are essential to validate and globalize its application.

KEYWORDS: Ayurveda, detoxification, metabolic syndrome, Panchakarma, Virechana