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Introduction: Avalehya (medicated semi-solid preparations) represent one of the most widely prescribed dosage forms in Ayurveda. Classical texts describe them as palatable, long-storable, and therapeutically versatile, with applications ranging from rasayana (rejuvenation) to management of respiratory, digestive, and metabolic disorders. Their semisolid base, often comprising jaggery, sugar, or honey, acts both as preservative and drug vehicle. Methods: A systematic narrative review was performed by consulting Ayurvedic classical texts (Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya, Sharangadhara Samhita), pharmacopeial standards, and modern pharmacological literature from databases including PubMed, Scopus, and Web of Science (1950–2025). Search terms included “Avalehya,” “Leha,” “Ayurvedic semisolid formulations,” and “herbal pastes.” Both experimental and clinical studies were included if they provided pharmacological, analytical, or therapeutic evidence. Results: Classical formulations such as Chyavanaprasha Avaleha, Agastya Haritaki Avaleha, and Kushmanda Avaleha demonstrate multifaceted therapeutic indications, especially in respiratory and metabolic disorders. Pharmacological studies show immunomodulatory, antioxidant, anti-inflammatory, adaptogenic, and antimicrobial activities. The sugar/honey base enhances palatability, stability, and shelf-life while facilitating mucosal absorption and sustained release. Modern analytical studies confirm the presence of bioactive phytoconstituents including flavonoids, glycosides, saponins, and polyphenols. Clinical evidence highlights their role in respiratory health, immune enhancement, digestive function, and general vitality. Discussion: Avalehya preparations parallel semisolid delivery systems in modern pharmaceutics, providing taste masking, dose flexibility, and synergistic herb–vehicle interaction. Despite promising evidence, challenges include lack of rigorous clinical trials, variability in raw materials, and inadequate standardization protocols. Conclusion: Avalehya formulations represent a scientifically relevant traditional dosage form with promising pharmacological actions. Integrating classical knowledge with modern pharmaceutics and standardization may unlock their full potential in contemporary healthcare.

KEYWORDS: Ayurveda, Avalehya, Leha, pharmacology, semisolid dosage forms