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Mutrashmari is a frequently encountered clinical condition in primary care, with more than one million cases reported annually in India. Epidemiological data indicate that approximately 12% of the population is predisposed to urinary stone formation. In Ayurveda, Mutrashmari is described as one of the Ashtamahagada (eight grave disorders) and is categorized as a Kaphapradhana Tridoshaja Vyadhi. Its clinical presentation closely parallels urolithiasis in modern medicine and is recognized as a significant contributor to morbidity due to severe pain, urinary obstruction, and recurrent episodes. The present work aims to evaluate the therapeutic efficacy of Shaman Chikitsa in the management of Mutrashmari with reference to urolithiasis. This study reports a single case involving a 65-year-old male who presented with acute right flank pain radiating to the lower abdomen, accompanied by burning micturition, dysuria, and a recent diagnosis of mild prostatomegaly. The patient had been asymptomatic one month prior but developed sudden and severe symptoms consistent with ureteric colic. A structured Shaman Aushadhi regimen was administered based on Ayurvedic principles targeting Kapha aggravation, Vata vitiation, and urinary obstruction. Substantial improvement was noted, with approximately 90% relief in both chief and associated complaints. The patient reported a marked reduction in pain, improved urinary flow, and enhanced functional status. No adverse effects were observed during the therapeutic period. In conclusion, Shaman Chikitsa demonstrated satisfactory effectiveness over 45 days, indicating its potential as a conservative management approach for Mutrashmari and improving overall quality of life. KEYWORDS Ayurveda; Mutrashmari; Shaman Chikitsa; Shaman Aushadhi; Urolithiasis; Urinary calculus; Urinary disorders