Introduction: The world is facing health emergency of Covid-19. Ayurveda preparations are known for their immunomodulatory as well as antiviral efficacies. Integrated approach and holistic management of Covid 19 patients is need of hour. Aim: This research was conducted to clinically validate safety and efficacy of Madhav Rasayan tablet, an Ayurvedic formulation in the management of Covid 19. Materials and Methods: In present RCT, moderate COVID 19 patients (n=60) were randomized in two parallel groups (n=30/ group). The interventional group (Treatment) received Madhav Rasayan tablet 250 mg twice a day for 30 days along with standard care (SOC) as per ICMR, while the control group received SOC alone. The primary outcome of the study was to evaluate improvement of clinical symptoms, reduction in levels of inflammatory markers, negative RT-PCR for Covid 19 on day 5 and day 10 of intervention. The secondary outcomes were to reduce supplemental oxygen, hospital stay and ICU admission. Total Covid antibodies and Covid IgG antibodies were assessed on day 10 and day 30 of the intervention. Improvements in certain subjective aspects were assessed through questionnaires. Results: Madhav Rasayan significantly improved symptoms of COVID 19 like cough, breathlessness, fatigue and reduced inflammatory markers like CRP. The significant population (40%) turned RT-PCR negative on 5th day along with improved quality of life. The antibody status in the intervention group was shown to be better. There was reduced hospital stay, need of supplemental oxygen and in intervention group than control. Conclusion: Madhav Rasayan can be good option for integrating with standard care protocols. There was significant viral load reduction and more negative RT-PCR reports. There was better prognosis, speedy clinical recovery and reduction in inflammatory markers. It is a promising immunomodulator to offer long-term protection by helping production of neutralizing antibodies. This study will pave the path for integrating Ayurveda interventions in management of Covid 19.