In the present times need is being felt for a change in paradigm from the current practice of modern medicine. This is not only to meet the challenges in diagnosis and treatment of chronic and complex diseases but also to address the variability in therapeutic outcome as well as evolve preventive measures in health and disease. The advent of genomics has provided a tremendous impetus to this area. However, there are a number of gaps before this is realized. Ayurveda, the ancient Indian system of predictive and personalized medicine still holds contemporary in the current era of P4 (predictive, preventive, personalized, and participatory) medicine and also has a promotive component. Ayurveda has documented methods for maintenance of health and personalized management of diseases. It is also widely practiced in most Indian communities despite sociocultural variations and many aspects for preventive health are also integrated into Indian traditional living. Despite this a large number of challenges exist in getting this system to mainstream and for its global acceptability. This review highlights some of these aspects and also proposes Ayurgenomics as a novel approach for integration of Ayurveda into current medical practice. © 2016 Elsevier Inc.