Background: In Ayurveda Sandhigata Vata caused by aggravation of Vata having features Shula,Shoths,Stambha,Asthisabda is closely co-related with OA in modern science. Modern medicine focuses on symptom management while Ayurvedic therapy offers a holistic approach, with Janu Vasti being a key intervention. Objective: To evaluate the therapeutic potential of Janu Vasti in managing Sandhigata Vata (knee OA), with emphasis on its Ayurvedic principles, procedure, pharmacological basis, and clinical outcomes. Materials and Methods: A detailed review was conducted using classical Ayurvedic texts and modern medical literature accessed through databases such as Pubmed, Google Scholar, and Medline. The procedure of Janu Vasti, its mode of action, and the pharmacodynamics of medicated oils were critically examined. Results: Janu Vasti, involving the localized application of warm medicated oils such as Mahanarayana Taila, Sahacharadi Taila.