Stroke is the leading cause of disability and more than half of the stroke survivors will end up severely impaired. The prevalence of stroke in India ranges from 40 to 270 per 100 000 population. Like any other surgical procedure, decompressive craniectomy is not without risk and cranioplasty also carries its own risks. Some of the complications arising out of these surgeries may require additional surgery which further increases the risk to the patient for neurological deterioration or death. The present article deals with a diagnosed case of post hemi craniectomy sequelae clinically presented as left sided hemiplegia, focal seizures/myoclonic jerks and irritable mood. The Ayurvedic diagnosis of pakshaghata was made and various panchakarma procedures were implemented along with internal Ayurvedic medicines. Two assessments were taken before and after treatment on NIH-SS (National Institute of Health Stroke Scale) and SS-QOL (Stroke Specific Quality of Life Scale). There is 57.1% relief on NIH-SS and 83.5% improvement found on SS-QOL in present case. Ayurvedic panchakarma procedures and medicines were found effective in the management of post hemi craniectomy sequelae. The recovery was promising and worth documenting.