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Stroke is a leading cause of death and disability worldwide, and India carries a substantial and growing share of this burden. Pakshaghata, described among the Vata disorders in Ayurveda, is widely correlated with hemiplegia due to stroke. Panchakarma is traditionally used for Pakshaghata and other neurological disorders through Snehana, Swedana, Basti, Nasya and related therapies, with the aim of supporting neurological recovery alongside Ayurvedic medicines. This article reviews the classical concept, the modern understanding of stroke recovery and rehabilitation, the Panchakarma procedures used, the limited clinical literature (including early work in Parkinson's disease), and the safety and integration issues. Panchakarma should be viewed as an adjunct to, not a replacement for, evidence-based acute stroke care and structured rehabilitation.