Varuna (Crataeva nurvala) is a medicinal plant well-known in Ayurvedic medicine and has been traditionally used for a variety of hepatic and urinary disorders. Its use in supporting liver health, including conditions like fatty liver disease, is primarily based on classical Ayurvedic texts and ethnobotanical reports. In traditional formulations, Varuna is often cited for its purported ability to reduce “kapha” and “meda” (fat), and to support liver and gallbladder function. Some Ayurvedic practitioners have used Varuna in combination with other herbs to aid in managing fatty liver, but the primary justification remains historical and anecdotal. Regarding scientific validation, there is limited preclinical evidence suggesting Varuna’s hepatoprotective effects in animal models, mostly focusing on general liver protection rather than specifically on non-alcoholic fatty liver disease (NAFLD). These studies are few, preliminary, and do not provide robust clinical data. There is a lack of high-quality human trials directly evaluating Varuna’s efficacy for fatty liver disease. In summary, the use of Varuna for fatty liver disease is mostly supported by traditional medicine systems, with only minimal and indirect scientific evidence. Its inclusion in herbal protocols for fatty liver should be considered as traditional and adjunctive rather than evidence-based by modern clinical standards.