Siraja Granthi is one among the Granthi Roga described in various Ayurvedic classics. It denotes a pathological condition characterised by an elevated, quickly developing and round swelling of veins, which are non pulsating and painless. Symptomatologies of Siraja Granthi indicate the correlation towards the varicose veins. Ayurvedic management has multiple time tested modalities of treatment such as external application of Sahacharadi Taila, internal Basti and Para surgical procedure such as Raktamokshana,for the management of Siraja Granthi. A hypothesis was made that, whether Raktamokshana by Siravyadha method which is comparatively safe, has extended systemic action quoted to be Ardha Chikitsa and can be employed in patients with Siraja Granthi / varicose veins. Case Presentation: A 39 year old male patient visited OPD of Shalya Tantra, GAMC, Bengaluru, who had presented with complaint of dull aching pain which aggravates specially by the end of the day and dilated, engorged veins over right lower limb for about 2 years associated with gradual onset of mild edema around the right ankle, discoloration and itching for last 4 months. It was planned to treat the patient with Raktamokshana by Siravyadha 4 sittings at an interval of 7 days and Sahacharadi Kashaya 15 ml Bid given internally for 28 days. Conclusion: Raktamokshana (Siravyadha) line of treatment was found to be beneficial in relieving pain, swelling, itching and discoloration around the affected regions of varicose veins.