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In the ancient India surgery was pioneered by Ayurveda. Shalya Chikitsa is a significant branch of Ayurvedic science. The name of the sage-physician Susruta is synonymous with surgery. From his treatise Susruta Samhita we come to know that thousand of years ago sophisticated methods of surgery were practiced in India. Topics of intestinal obstructions, bladder stones, and the use of dead bodies for dissection and learning were taught and practiced in ancient India. The original text of Susruta discusses in detail about an exhaustive range of surgical methods including about how to deal with various types of tumors, internal and external injuries, fracture of bones, complications during pregnancy and delivery, and obstruction in intestinal loop. Susruta was the first surgeon to develop cosmetic surgery. His surgical treatment for trichiasis can be to some of the modern operative techniques used for this eye disease. The use of various surgical instruments is also described in the Susruta Samhita for the treatment. The instruments described were made from stone, wood and other such natural materials. The treatment of Shalya Tantra was popular because this could give fast relief as compared to the slow process of recovery from medicines or herbs. Diseases, which requires instant treatment in those cases shalyachikitsa was the best method. Charaka the best-known physician of Ayurvedic medicine also recommended for Shalya Tantra in treatment of certain diseases, which required immediate attention like hemorrhoids. The long foreign rule in India and lack of promotion stalled the progress of Ayurvedic surgery in the middle of the second millennium. This is the branch of Ayurveda, which deals with the treatment of Agni.