The fundamental principles of Ayurveda are briefly reviewed. The ancient classification of arthritis is described along with the comparisons to the modern system. Though the diagnosis is historical and clinical, it is based on the tridosha hypothesis. The Ayurvedic pathogenesis links arthritis to the gut. Management chiefly consists of diet and lifestyle changes, the panchkarma process, and herbal drugs. The rasayana concept of immunomodulation is introduced. Clinical ethno-validation of the ancient therapy is necessary to meet the modern requirements and set up an interface with modern medicine.