Due to its higher recurrence incidence, Sushruta ranked Bhagandara as one of the Ashta Mahagaroga's ( eight important diseases ) in Ayurveda. These days, sedentary lifestyles and other reasons are contributing to the rise of anorectic illnesses. The term Bhagandara, which is made up of the words Bhaga and Darana, refers to a prevalent condition that affects the anorectal area surrounding the anus and extending to the genitalia. Pidika's formation, which is typified by an opening around Guda Pradesha with a painful discharge, drives the growth of Bhagandara. Fistula in ano is still a confusing surgical condition despite almost two millennia of efforts to prevent its recurrence and complications, despite the evaluation of numerous approaches over the past few decades. Fistula in ano has signs and symptoms with Bhagandara, which is recorded in the classics of Avurveda. Many current scientific modalities are utilized to cure Bhagandara, however as of yet, no one modality has been shown to be effective in treating fistula . An Ayurvedic parasurgical method called ksharasutra provides a less invasive option. A modified version, Guggulu Tankana Ksharasutra, makes use of both Guggulu and Tankana to improve accessibility and efficacy. Using both contemporary research and traditional Ayurvedic references, this review addresses its preparation, mechanism, therapeutic results, and advantages.