Pratishyaya occupies a unique and significant position in classical Ayurveda, being described not only as an independent disease but also as a premonitory symptom (Purvarupa), a complication (Upadrava), and a sequel (Uttararupa) of several systemic disorders. The Ayurvedic Acharyas recognized Pratishyaya as a disease of profound clinical importance because of its close association with the disorders of the Urdhvajatrugata region and its potential to progress into chronic and debilitating conditions when neglected. Owing to its recurrent nature and tendency to affect multiple structures of the upper respiratory tract, it has been regarded as a substratum capable of giving rise to a wide spectrum of diseases. This significance is reflected in the detailed descriptions and repeated references found throughout the Brihattrayi—namely the Charaka Samhita, Sushruta Samhita, and Ashtanga Hridaya—as well as the Kashyapa Samhita, where special emphasis is placed on its occurrence and management in children.From an Ayurvedic perspective, Pratishyaya is primarily a Tridoshaja disorder with varying predominance of individual Doshas, resulting in distinct clinical manifestations and therapeutic considerations. The disease develops due to the interaction of etiological factors (Nidana), impairment of Agni, vitiation of Doshas, and involvement of the Pranavaha and Urdhvajatrugata Srotas, ultimately producing characteristic nasal and systemic symptoms. Classical texts provide a systematic account of its etiopathogenesis, beginning with causative factors (Nidana), followed by premonitory signs (Purvarupa), cardinal clinical features and classification (Rupa), pathogenesis (Samprapti), complications (Upadrava), prognosis, and comprehensive principles of management (Chikitsa). Such an organized description highlights the depth of Ayurvedic understanding of this commonly encountered disorder.This article presents a concise conceptual review of the etymology, etiological factors (Nidana), premonitory features (Purvarupa), clinical manifestations and classification (Rupa), pathogenesis (Samprapti), complications (Upadrava), differential diagnosis, and therapeutic principles (Chikitsa) of Pratishyaya.