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Background: Prakriti, the innate constitution of an individual determined mainly at conception, is the foundation of individualised care in Ayurveda. Interest in prakriti has increased with the growth of personalised and precision medicine. Objective: To review the classical description of prakriti, its types and determinants, the methods of assessment, and the evidence for molecular and clinical correlates, with attention to limitations. Methods: Classical texts were read in translation. PubMed was searched in November 2026 for reviews and studies on prakriti, Ayurgenomics and personalised medicine. Results: The Samhitas describe seven types of prakriti (three single-dosha, three dual-dosha and one balanced) and assign a role to parental, environmental and mental factors. Assessment relies on questionnaires and clinical examination, which suffer from subjectivity. Genomic studies report differences between prakriti types, including variants in pharmacogenomic genes, and recent work proposes digital and artificial intelligence-based tools and epigenomic analysis. The evidence is promising but limited by small samples and heterogeneous methods. Conclusion: Prakriti provides a framework for stratifying individuals and tailoring interventions. Its translation into precision medicine depends on standardised assessment, replication of molecular findings and prospective clinical validation.