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Nadi Vrana is a chronic suppurative disorder described extensively in Ayurvedic surgical literature and is considered one of the most challenging conditions under Dushta Vrana. The disease is characterized by the formation of a tubular structure associated with persistent discharge, pain, tenderness, inflammation, and delayed healing. Acharya Sushruta described Nadi Vrana as a pathological condition resulting from improperly managed Vrana Shopha, retained foreign bodies, trauma, or chronic infection. The clinical presentation closely resembles sinus disorders described in contemporary surgery. Despite significant advancements in modern surgical techniques, recurrence, prolonged healing, postoperative morbidity, and patient discomfort continue to remain major therapeutic concerns. Ayurveda offers a comprehensive understanding of Nadi Vrana through the concepts of Dosha, Dushya, Agni, and Srotas involvement and recommends multiple treatment modalities including Shastra Karma, Kshara Karma, Agni Karma, and Varti Prayoga. The present review critically evaluates the Ayurvedic concept of Nadi Vrana, its etiopathogenesis, classification, clinical features, diagnosis, and management while correlating these concepts with the contemporary understanding of sinus disease. The review also highlights current evidence and future research opportunities in the field of Ayurvedic wound care. Keywords: Nadi Vrana, Sinus, Dushta Vrana, Shalya Tantra, Ayurveda, Varti Kalpana, Wound Healing, Chronic Sinus.