Background: Hypertension is one of the foremost lifestyle disorder nowadays, which if untreated leads to many fatal conditions such as stroke, heart attack etc., The Siddha system of medicine is one of the oldest traditional systems of medicine practiced by our Siddhars in Southern India to lead a healthy life. It contains many effective medicines which are useful for both preventive and therapeutic purposes. In Siddha system, systemic hypertension is indicated as Kurudhiazhal Noi. The aim of the present study was to explore the effective management of kurudhiazhal noi (Systemic hypertension) with J. adhatoda (Adhatodai) leaves decoction. Objective: The purpose of the case series is to evaluate the effective management of Kurudhiazhal noi (Systemic Hypertension) with Justicia adhatoda leaves decoction in newly diagnosed hypertensive cases.