Stroke is a common medical emergency and the second leading cause of death worldwide. In Ayurveda stroke is described as Pakshaghata.  All therapeutic measures may be started after crossing the acute phase of attack. Ayurvedic management with Panchakarma procedure like Abhyanga, Vashpa swedana, Anulomana, & Shirodhara along with oral Ayurveda medication are effective in the management of Pakshaghata. These approaches are safe, cost effective and easy to follow. Herbs like Ashwagandha, Brahmi, Eranda, Rasona, Rasna etc Medicines like Mahavatavidwamsana, Balarista, Dashmoola Arista, Sarasawathaarista, Bhihat vata Chintamani, Ekangavira rasa, Sacharadi kasahya, Gandarwahastadi qwatha etc are common in practice, but the duration of the treatment, dosage, selection of herbs, type of Panchakarma, will be adjusted and planned by the ayurvedic doctors only according to the clinical findings and response to the therapy.