Arsha (Piles) is an extremely common problem in all anorectal disorders. Arsha is clinically an engorged condition of haemorrhoidal venous plexus characterized by inflamed or prolapsed pile mass, bleeding per rectum. The term haemorrhoids usually resulted by straining during defecation, chronic constipation or diarrhoea, pregnancy etc. Main aetiological factor Mithyaaahar-vihar and sedentary life style. In modern medical science many techniques like sclerotherapy, cryosurgery, Rubber band ligation, Infrared photo coagulation, Laser therapy, stapled haemorrhoidectomy, Open haemorrhoidectomy etc. are in practice where in the result was found to be in less satisfactory. But in Ayurveda fourfold management of Arsha has been indicated viz. Bheshajkarma, Kshar Karma, Agnikarma and Shastra Karma according to chronicity and presentation of the disease. Among these, Bheshaj Chikitsa and Kshar Karmas show wonderful results in management of Arsha. Here an attempt has been made to review the disease along with its management