Shalyaja Nadivrana is of Agantuja Vranabedha. Nidana Panchaka is described in Sushruta Samhita Nidhana and Chikitsa Sthana. Presence of “Shalya” is hindering factor for healing. Management of Nadivrana includes Ksharasutra ligation. Pilonidal sinus is acquired sinus occurring in young hirsute men’s commonly seen at intergluteal cleft caused by hair penetrating the skin resulting in Pilonidal abscess which gradually forms into sinus with presence of “Hair” leading to wound discharge. It is one of the troublesome diseases which doesn’t respond to medical management till hair is evacuated. The current surgical procedures adopted have surgical risk and recurrence as well. Guggulu and Karaveera is abundantly available and can be preserved easily for long time. Hence can be used as substitute to the standard Ksharasutra. The present study “A study on the effectiveness of Guggulu based Karaveera Ksharasutra in comparison with Apamarga Ksharasutra in the management of Shalyaja Nadivrana w.s.r. to Pilonidal Sinus”was conducted in SJIIM hospital Bengaluru with 40 patients randomly allotted into 2 groups namely - Group A and Group B. Assessment was done based on subjective parameters like (pain, discharge) and objective parameters like (length of tract, tenderness). Observation was done before treatment and on every 7th day till tract is completely cut and healed. Assessment of Pain, discharge, length of tract and tenderness in Group-A showed 100%, 100%, 100% and 100% improvement and in Group-B showed 97.92%, 100%, 100% and 100% respectively. UCT in Group-A is 6.58% and Group-B is 9.15%. Overall results of group A and B is 100% and 99.5% respectively. Statistical analysis revealed that the effectiveness of Guggulu based Karaveera Ksharasutra in Shalyaja Nadivrana is as effective as Apamarga Ksharasutra w.s.r. to pilonidal sinus.