Vatakantaka is a Vata-dominant disorder affecting the Gulpha Sandhi region, characterized by severe heel pain and inflammation. In contemporary medicine, it can be correlated with calcaneal spur, a common cause of chronic heel pain leading to functional disability. Agnikarma is described in Ayurvedic classics, especially by Acharya Sushruta, as an effective parasurgical procedure for Vata-Kapha predominant disorders involving Asthi, Sandhi, and Snayu. Aim To study the efficacy of Mruttika Shalaka Agnikarma in the management of Vatakantaka with special reference to calcaneal spur. Materials and Methods An open-label, single-group clinical study was conducted on 30 patients diagnosed with Vatakantaka/calcaneal spur based on clinical features and X-ray findings. Agnikarma was performed using heated Mruttika Shalaka at the maximum point of tenderness once weekly for four sittings. Pain was assessed using the Visual Analogue Scale (VAS) before and after treatment. Statistical analysis was carried out using the Wilcoxon Signed Rank Test. Results The mean VAS score reduced from 8.13 ± 0.94 before treatment to 5.07 ± 1.39 on 28th day of treatment, showing an overall improvement of 38.81%. The reduction in pain was found to be statistically highly significant (p < 0.001). Clinically, most patients showed a shift from severe pain to mild and moderate pain categories after treatment. Conclusion Mruttika Shalaka Agnikarma showed statistically and clinically significant improvement in pain management of Vatakantaka (calcaneal spur). The therapeutic effect may be attributed to the Vata-shamaka and Shoolahara properties of Agnikarma. The procedure was found to be safe, effective, and economical. Further randomized controlled trials with larger sample sizes are recommended to validate these findings.