Sheetapitta is a Twak vikara described in Ayurveda, characterized by kandu, pidika, daha, and sheeta Sparsha. It is primarily caused by vitiation of Vata and Kapha dosha along with Pitta dosha dushti. Due to Agnimandya and Ama formation, the vitiated doshas manifest in the twak, leading to recurrent episodes affecting the patient’s daily activities. In the present case study, a 32-year-old male patient presented with classical features of Sheetapitta for a duration of 3 months. The condition was diagnosed on the basis of Ayurvedic lakshanas. The patient was managed with Shodhana chikitsa as the planned line of treatment. The treatment protocol included Deepana-Pachana followed by Purva karma (Snehana and Swedana), and Pardhana krama (Virechana karma) and Paschata karma (Samsarjana krama) advised along with appropriate Shamana aushadhi. Assessment was done based on reduction in kandu, pidika and daha. After completion of therapy, significant relief was observed in all symptoms, with marked improvement in overall condition and no recurrence during follow up. This case study highlights the effectiveness of Virechana karma in eliminating vitiated Pitta dosha and purifying Rakta, thereby playing a key role in the management of Sheetapitta.