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Introduction: Ayurveda, the traditional Indian system of medicine, emphasizes the therapeutic use of polyherbal formulations, with Kashayam (decoctions) being one of the most widely prescribed dosage forms. Decoctions involve aqueous extraction through boiling, which is believed to preserve bioactive phytoconstituents in a synergistic manner. In modern pharmacology, solvent extraction methods such as ethanol, methanol, chloroform, and hydroalcoholic extractions are used to isolate bioactive compounds with high specificity. A comparative understanding of Kashayam preparation and modern extraction-based pharmacology offers opportunities to bridge traditional wisdom with contemporary science. Methods: A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, AYUSH Research Portal, and classical Ayurvedic texts including Charaka Samhita and Sushruta Samhita. Studies were included if they examined Ayurvedic decoctions, aqueous extracts, or solvent-based extractions with pharmacological evaluations. Both preclinical and clinical reports were considered, while studies lacking pharmacological or analytical data were excluded. Results: Kashayam preparations exhibit a broad pharmacological spectrum, including anti-inflammatory, immunomodulatory, and metabolic regulatory actions, attributed to water-soluble phytochemicals such as tannins, flavonoids, alkaloids, and glycosides. In contrast, solvent-based extractions often yield concentrated fractions of lipophilic compounds like terpenoids and sterols, showing potent activity in experimental models. Comparative analyses reveal that while Kashayam ensures holistic synergy and safety through traditional methods, modern extraction provides mechanistic clarity, higher reproducibility, and targeted bioactivity. Discussion: This review highlights the convergence and divergence of traditional decoction-based formulations and modern pharmacological extraction techniques. Integrating the holistic safety of Kashayam with the precision of modern extraction may pave the way for standardized, evidence-based herbal medicines.

KEYWORDS: Ayurveda, decoction, extraction, Kashayam, pharmacology