Adverse Drug Reactions (ADRs) represent a significant challenge to patient safety across all systems of medicine, including Ayurveda. Despite the long-standing use of Ayurvedic medicines and their general perception as safe, adverse reactions have been increasingly reported due to factors such as inappropriate drug selection, improper dosage, prolonged use, drug–drug interactions, herbo-mineral formulations, and compromised drug quality. In response to these concerns, the Ministry of AYUSH, Government of India, established the Ayush Pharmacovigilance Program of India (APvPI) to systematically monitor and evaluate ADRs related to AYUSH medicines. This article aims to describe the concept of ADRs in Ayurveda, the importance of ADR reporting, the structured national pharmacovigilance framework, and the standardized reporting process followed in India. Strengthening ADR reporting practices among Ayurvedic practitioners is essential for enhancing drug safety, promoting rational drug use, and integrating Ayurveda into evidence-based healthcare systems.