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Abstract Introduction: Amavata, a debilitating disease described in Ayurveda, can be correlated clinically with Rheumatoid Arthritis (RA) in modern medicine. It arises from the pathological combination of Ama and Vata dosha, leading to painful inflammation of joints. Though the concept of Sama (presence of Ama) and Nirama (absence of Ama) avastha is central to treatment, its practical clinical identification remains under-researched. Materials and Methods: This observational clinical study was conducted on 45 patients diagnosed with Amavata, registered under CTRI. Patients were evaluated for specific Sama and Nirama lakshanas (clinical signs and symptoms), both subjectively and with the aid of laboratory diagnostics. The study was conducted at Seth Tarachand Ramnath Charitable Hospital, Pune over a defined period. Patients already diagnosed with Amvata were analysed and sama and Nirama avasta was accessed on basis on specially designed case record format. Inclusion and exclusion criteria ensured homogeneity. Results: Out of the 45 patients, 32 were identified in Sama Avastha, while 13 presented in Nirama Avastha. Key symptoms like Angamarda, Gaurava, Aruchi, Agnimandya, and Jwara were predominantly observed in Sama Avastha. Nirama avastha showed symptoms such as Sandhishula without systemic features. Laboratory data supported elevated ESR and CRP during Sama phase, correlating with inflammatory activity. Most common predisposing factors included improper dietary habits (Viruddhahara, Ajirna) and sedentary lifestyle. Discussion: The findings emphasize the diagnostic clarity provided by systematically assessing Sama and Nirama Avastha in Amavata patients. The study focused on identifying avastha-specific lakshanas as defined in Ayurvedic texts and validated their presence through clinical patterns and modern inflammatory markers (e.g., ESR, CRP). The research reveals a consistent clinical correlation: systemic symptoms like Gaurava, Angamarda, Jwaraa, and Agnimandya were significantly associated with the Sama Avastha, while localized joint symptoms without systemic involvement indicated the Nirama Avastha. This stage-wise identification provides a practical diagnostic framework that can be used to precisely categorize patients, aiding in case documentation, prognosis, cross-disciplinary communication and precise treatment. Conclusion: This study validates the clinical differentiation between Sama and Nirama Avastha in Amavata and underscores its importance in personalized Ayurvedic treatment. Integrating classical diagnostics with modern markers offers a comprehensive model for disease staging and management. Further multicentric studies with larger sample sizes are warranted.