Karshya, an emaciated condition described in Ayurveda, represents a state of undernutrition and Dhatu Kshaya (tissue depletion). In children, Karshya manifests as low body weight, poor immunity, and delayed development, closely paralleling the modern concept of chronic undernutrition or Protein Energy Malnutrition (PEM). Ayurveda, being a comprehensive health science, offers a unique perspective by focusing not only on nutritional intake but also on digestion (Agni), metabolism, and tissue assimilation. Panchakarma, a specialized therapeutic regimen in Ayurveda, aims to restore physiological balance and enhance nutrient absorption by cleansing and rejuvenating the body. The present conceptual review highlights the significance of Panchakarma in the management of childhood Karshya, emphasizing its role in improving digestion, enhancing Dhatu Pushti (tissue nourishment), and promoting overall growth and development.