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Background: Nidana panchaka is the five-fold scheme of diagnosis of Ayurveda: nidana (cause), purvarupa (premonitory signs), rupa (signs and symptoms), upashaya (therapeutic or exploratory response) and samprapti (pathogenesis). It organises the diagnostic information that a physician is expected to gather. Objective: To review each component of the nidana panchaka, to describe its logic in terms of the pramana scheme and clinical reasoning, and to compare it with modern diagnostic methods. Methods: Classical texts were read in translation. PubMed was searched in November 2026 for papers on nidana panchaka, Madhava Nidana and Ayurvedic diagnosis. Results: The five components together provide a causal, predictive, descriptive, response-based and mechanistic account of disease. Samprapti is further subdivided into several types, and upashaya is used as a diagnostic aid when signs are unclear. The scheme corresponds in part to aetiology, prodrome, clinical features, therapeutic trial and pathophysiology. Recent clinical papers use the scheme and related concepts to interpret conditions such as hypertension, COVID-19 and metabolic syndrome. Conclusion: Nidana panchaka is a coherent diagnostic framework that can be adapted to structured case reporting and teaching. Evaluation of its reliability and predictive value requires standard definitions and prospective studies.