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Introduction: Surgical instruments have played a pivotal role in the development of Ayurveda, especially as described in Sushruta Samhita. The classification of instruments into Yantra (non-cutting tools) and Shastra (cutting tools) reflects remarkable surgical precision in ancient India. Their relevance continues in modern surgery, where several instruments find parallels with contemporary designs. Methods: This review was conducted by systematically analyzing primary Ayurvedic texts (Sushruta Samhita, Charaka Samhita, Ashtanga Hridaya) alongside secondary commentaries and modern scholarly literature. Searches were performed in PubMed, Scopus, Web of Science, and AYUSH Research Portal using keywords such as “Ayurveda surgical instruments,” “Yantra,” “Shastra,” and “Sushruta surgery.” Articles, reviews, and clinical-historical reports published between 1990–2025 were included. Results: The classical classification lists over 100 Yantras and 20 Shastras, including forceps, probes, needles, and knives, many of which mirror modern surgical instruments. Yantras were primarily used for grasping, probing, squeezing, and draining, while Shastras were designed for excision, incision, and dissection. Comparative analyses show clear similarities between ancient forceps (Svastika Yantra) and modern artery forceps, or Mandala Shastra and scalpels. Evidence suggests Sushruta’s innovations influenced Greco-Arabic medicine and eventually European surgery. Discussion: While Ayurveda offered detailed instrument descriptions, modern surgery has improved materials, ergonomics, and sterilization. The continuity of surgical principles demonstrates Ayurveda’s lasting contributions. However, research gaps remain in experimental archaeology, museum preservation, and systematic comparison with modern instruments. Conclusion: The historical evolution of Yantra and Shastra in Ayurveda illustrates the scientific ingenuity of ancient Indian surgeons. Modern recognition of these tools not only highlights their relevance but also opens avenues for cross-cultural medical heritage research and integrative surgical studies.

KEYWORDS: Ayurveda, history of surgery, Shastra, Sushruta, Yantra