Hydrosalpinx, a major contributor to tubal-factor infertility, is characterized by pathological dilatation of the fallopian tube with serous fluid accumulation due to distal obstruction. Modern management typically involves surgical intervention, which may compromise fertility. In Ayurveda, such conditions are understood as Artava Vaha Srotas Dushti involving Kapha-Vata Dushti, Ama Sanchaya, and Srotorodha. This case report illustrates the successful management of unilateral hydrosalpinx through Virechana Karma (therapeutic purgation) and Uttara Basti (intrauterine administration) with Kumari Taila. A 32-year-old nulliparous woman presented with primary infertility for 4 years, irregular menstruation, lower abdominal pain, and leucorrhoea. Diagnostic evaluations (TVS and HSG) confirmed left-sided hydrosalpinx with distal tubal block. Treatment involved Deepana-Pachana, Snehapana, Abhyanga-Swedana, followed by Virechana Karma, post-purification administration of Punarnavadi Kashaya and Kanchanara Guggulu, and Uttara Basti with Kumari Taila over 3 months. Post-treatment outcomes showed significant symptomatic relief, regularized menstruation, restored digestion, and improved vitality. Radiological assessments revealed reduced hydrosalpinx size and restored tubal patency with free spillage on HSG. This case highlights the efficacy of classical Ayurvedic interventions as non-invasive, fertility-preserving options in the management of hydrosalpinx, validated through modern diagnostic tools.