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This case study reports a 30-year-old male patient diagnosed with Chronic Spontaneous Urticaria (CSU), presenting with severe generalized pruritus and recurrent wheals distributed over the entire body for the past 4 years. The patient did not achieve significant symptomatic relief despite prolonged treatment with conventional antihistamines, Autologous Serum Therapy (AST), and Omalizumab (OMA). The patient was clinically evaluated and managed through Ayurvedic Panchakarma interventions, including Snehapana (therapeutic administration of unctuous substances such as ghee and oil), Vamana, and Virechana, along with internal medications prescribed according to the principles of Seethapitta Chikitsa. Disease activity was assessed using the validated Weekly Urticaria Activity Score (UAS7), recorded at baseline, after Vamana, after Virechana, and during follow-up. Quality of life was evaluated at baseline and after follow-up using the Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL). The outcomes demonstrated complete remission of disease activity along with marked improvement in quality of life, as reflected by the assessment scores. Hematological and biochemical investigations further indicated the safety and therapeutic efficacy of Ayurvedic management in this case of Chronic Spontaneous Urticaria.