Vatarakta is a chronic, painful joint disorder described extensively in the Ayurvedic classics, and is widely correlated with gout in contemporary biomedicine. The disease arises when aggravated Vata and vitiated Rakta (blood) act upon one another, obstructing the channels and lodging characteristically in the small joints of the extremities—most typically the great toe—a presentation that closely mirrors the classical podagra of gout. This review consolidates the etiological factors (Nidana) responsible for Vatarakta as enumerated by Charaka, SuShruta, Vagbhaṭa and Madhavakara, examines the pathogenesis (Samprapti) and clinical features, and correlates these with the modern concept of hyperuricemia and monosodium urate crystal deposition. The role of contemporary investigations in confirming the diagnosis is discussed, followed by a structured account of Ayurvedic management encompassing avoidance of causative factors (Nidana Parivarjana), purificatory therapies (Shodhana )—particularly bloodletting (RaktamokShana)—palliative medication (Shamana), and dietetic regulation (Pathya-Apathya). The review concludes that a lifestyle- and diet-driven etiological model of Vatarakta aligns remarkably with the epidemiology of gout, and that an integrative approach centred on nidana parivarjana offers a rational framework for prevention and long-term management.