Bhagandara, or Fistula-in-Ano as it is termed in modern medical parlance, is a persistent and distressing condition that gives rise to an abnormal connection between the anorectal canal and the perianal skin. While conventional surgical approaches to the condition prove adequately effective, they tend to produce high rates of complications and recurrences. Hence, this study. which sets out to explore the effectiveness of Ksharasutra, an Ayurvedic para-surgical intervention, regarding the management and treatment of Bhagandara. Ksharasutra treatment is performed by inserting a medicated thread, prepared specifically for the purpose, along the fistulous tract, where the thread slowly cuts through the tract and healing it over a period. The patient chosen for inclusion in the case study is a 35-year-old male who displayed the classic characteristic signs of suffering from a low trans-sphincteric fistula on initial presentation, i.e. recurring secretion of blood, pus, and other discharge from a swelling in the perianal region as well as severe pain. The treatment was performed over 8 weeks, with regular weekly changes of the thread and visits to the clinic. Significant improvement was observed, including the complete healing of the fistulous tract, with no complications or relapses noted post-treatment. The study concludes the potential of Ksharasutra treatment as a viable alternative to conventional approaches to the treatment of Bhagandara, as it is not only safer a significantly lower rate of complications and recurrence but also promotes quicker healing and a higher quality of life for patients. The study underscores the need to develop the standardized protocol for treatment and test the long-term effects of Ksharasutra therapy for Fistula-in-Ano on broader sample sizes.