In routine surgical discussions, Shalya is usually understood as a foreign body that has entered the body from outside. However, Sushruta Samhita presents a much wider and more sophisticated interpretation. For Sushruta, a Shalya is not only an external object like a thorn or splinter but also any internal pathological factor that behaves like a thorn, producing pain, obstruction, inflammation, or irritation. These internal factors include calculi, clots, slough, aggravated doshas, parasitic irritants and even compressive forces such as fetal pressure. This article brings together the classical references, commentarial interpretations, clinical applications and modern equivalents of the broader Shalya concept. The intention is to highlight how this expanded understanding enriches both Ayurvedic theory and contemporary surgical reasoning.