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Background: Srotas, the micro- and macroscopic channels described in Ayurvedic medicine, represent a sophisticated network governing the flow of biological substances, metabolic substrates, and consciousness-related impulses throughout the body. Their structural and functional integrity is indispensable for health (Swasthya), while any derangement — collectively termed Srotodushti — constitutes the foundational mechanism underlying virtually all disease processes in classical Ayurveda. Objective: This review aims to critically examine the classical Ayurvedic concept of Srotodushti — its definition, classification, aetiology (Nidana), pathogenic types, and diagnostic significance — and to establish integrative correspondences with contemporary biomedical mechanisms of channel dysfunction, transport biology, and systems pathology. Methods: A review of primary classical Ayurvedic texts (Charaka Samhita, Sushruta Samhita, Ashtanga Hridayam) was undertaken alongside a structured search of PubMed, Scopus, and Ayush research databases for contemporary peer-reviewed publications addressing channel biology, transport pathophysiology, and integrative frameworks. Results: Thirteen primary Srotas (plus three exclusively female channels) are identified in classical texts, each with defined root organs (Moolasthana), specific substrates, and four classical dushti types: Atipravrutti (hyperfunctional flow), Sanga (obstruction), Vimarga Gamana (aberrant trajectory), and Siragranthi (nodular formation). Each maps convincingly onto biomedical constructs including hypersecretion syndromes, vascular and lymphatic obstruction, ectopic pathology and metastasis, and neoplastic transformation. The mediating role of Ama (biotoxin of incomplete metabolism) as a universal sroto-obstructing agent is highlighted, with parallels to endotoxaemia, unfolded protein responses, and damage-associated molecular patterns (DAMPs). Conclusion: Srotodushti provides a clinically applicable, mechanistically coherent, and translationally relevant framework for understanding the origin and progression of disease. Integration of this concept with modern pathophysiology can enhance both diagnostic precision and therapeutic strategy in integrative clinical practice and research. Keywords: Srotodushti, Srotas, Ayurvedic pathogenesis, Nidana Panchaka, Ama, channel dysfunction, integrative medicine, Samprapti, disease mechanism