Sri Lanka developed its own Ayurvedic system based on a series of prescriptions handed down from generation to generation over a period of 3,000 years. The ancient kings, who were also prominent physicians, sustained its survival and longevity. King Buddhadasa (398 AD), the most influential of these physicians, wrote the Sarartha Sangrahaya, a comprehensive manuscript which Sri Lankan physicians still use today for reference.

Ancient inscriptions on rock surfaces reveal that organized medical services have existed within the country for centuries. In fact, Sri Lanka claims to be the first country in the world to have established dedicated hospitals. The Sri Lankan mountain Mihintale still has the ruins of what many believe to be the first hospital in the world. Old hospital sites now attract tourists, who marvel at the beautiful ruins. These places have come to symbolize a traditional sense of healing and care, which was so prevalent at that time.

Historically the Ayurvedic physicians enjoyed a noble position in the country's social hierarchy due to their royal patronage. From this legacy stems a well-known Sri Lankan saying: "If you can not be a king, become a healer." Along with Buddhism, the interrelationship between Ayurveda and royalty continues to influence politics in Sri Lanka.

Ayurveda is a discipline of the upaveda or "auxiliary knowledge" in Vedic tradition. It is treated as a supplement or appendix of the Rigveda. However, some believed that Atharva-Veda is the prime origin of Ayurveda. The samhita of the Atharvaveda itself contains 114 hymns or incantations for the magical cure of diseases. Charak has advised in his samhita that physicians should adhere to Atharva-Veda. Origins of Ayurveda have been traced back to 5,000 BCE, originating as an oral tradition. Later, as medical texts, Ayurveda evolved from the Vedas.There are various legendary accounts of the "origin of Ayurveda", e.g., that the science was received by Dhanvantari (or Divodasa) from Brahma.Tradition also holds that a lost text written by the sage Agnivesh, a student of the sage Bharadwaja, influenced the writings of Ayurveda.