Bhallataka (Semecarpus anacardium Linn.), categorized under Upavisha (sub-toxic substances) in Ayurveda, is a potent medicinal drug widely used in various therapeutic formulations. Despite its significant pharmacological benefits, its application in clinical practice is often limited due to its well-known toxic effects, particularly local adverse reactions such as (burning sensation), (inflammation), (blister formation), and (itching). These manifestations are frequently observed in the Indian population, where Bhallataka is commonly utilized in both classical and folk practices, often without adequate purification (Shodhana) or precautionary measures. Although systemic toxicity of Bhallataka is relatively rare, its local toxic effects are more prevalent and sometimes severe, necessitating immediate and effective management. Modern medicine currently lacks specific targeted therapies for managing such localized toxic reactions, thereby highlighting a critical gap in treatment approaches. In contrast, Ayurveda offers a wide array of therapeutic interventions, particularly through Lepa Kalpana (topical applications), which are described in classical texts for managing skin-related toxicities and inflammatory conditions. This review aims to systematically explore and compile references from various Ayurvedic literatures regarding the management of Bhallataka-induced local toxicity. Emphasis is placed on identifying, analyzing, and summarizing different Lepa formulations and their therapeutic efficacy in alleviating local symptoms.