Mukkudi is a traditional Ayurvedic formulation widely practised in Kerala, exemplifying the Ayurvedic principle of Ahara as Aushadha (diet as therapy). Although not explicitly described in the major classical Ayurvedic treatises, Mukkudi is extensively documented in regional compendia such as Sahasrayogam, Arogyarakshakalpadruma, Chikitsamanjari, etc. It is classified as a Pramatya kalpana under both Kwatha and Anna kalpana and is primarily indicated for gastrointestinal and metabolic disorders. It is prepared predominantly using Takra (buttermilk) and herbs possessing Deepana–Pachana, Vatanulomana, and Grahi properties, Mukkudi is therapeutically applied in postnatal care for Agni deepana, Vata shamana, and systemic recovery, in paediatric practice for conditions such as Grahani, Atisara, and Krimi, and in ritual contexts as a medicated prasada, notably Nelluvai Mukkudi. Physiologically, Mukkudi supports digestion, regulates Dosha balance, enhances metabolic function, facilitates neuro-hormonal balance in the postpartum period, and contributes to gut microbiota modulation through the probiotic effects of buttermilk. More than 40 formulations are described across regional texts, targeting disorders including Jwara, Pandu, Arshas, Atisara, and Grahani. This review aims to highlight Mukkudi as a scientifically relevant traditional dietary formulation, emphasizing its therapeutic rationale, physiological mechanisms, and potential role in contemporary integrative healthcare. Contemporary insights into gut health and microbiome science further support its relevance in integrative healthcare, underscoring the need for systematic pharmacological and clinical validation to enable its broader therapeutic application.