Acute traumatic knee pain is a frequent musculoskeletal complaint in the elderly, commonly caused by sudden twisting injuries and characterized by severe pain, swelling, and restricted mobility. Conventional management mainly relies on non-steroidal anti-inflammatory drugs and supportive measures; however, immediate and sustained relief may not always be achieved. In Ayurveda, trauma is categorized under Agantuja Nidana and results in aggravation of Vata Dosha, described as Aghataja Vata. Severe pain (Vedana) and functional restriction (Cheshta Avarodha) indicate a Vata-dominant presentation. When intense and disabling, the condition may be considered an Atyayika Avastha, requiring urgent intervention. In the current case report, a 62-year-old female presented with acute left knee pain (VAS 10/10), swelling, and inability to lift the leg following a twisting injury. Managed as an acute Vata emergency, Agnikarma was performed at the most tender points around the knee, followed by Viddha Karma two anguli above Kshipra Marma, along with internal Vata-pacifying medicines. Pain reduced by nearly 90% within one hour (VAS 1–2/10), and complete recovery occurred within three days without adverse effects. This case was selected to highlight the rapid analgesic and functional benefits of Agnikarma and Viddha Karma in acute traumatic conditions, emphasizing their potential role in Ayurvedic emergency management.