Introduction: Siddha system of medicine is one of the oldest traditions of health care in the Indian sub-continent and well documented and replete with novel therapeutic interventions and treatment modalities. According to the mode of application, the Siddha medicines could be categorized into two classes: Aga marundhugal (Internal medicine) and Pura marundhugal (External medicine). External therapy procedures are as important as in the management of Health and Disease. Most of these therapies are aimed at maintaining a healthy balance of three humors Vali, Azhal, Iyyam and also the seven tissue types of the body. Kuruthivaangal (Blood Letting) is an external method of application of sharp instruments to leak or remove the blood from the abscess, cyst, keloid or the area where the accumulated blood is seen. In this type of treatment, a minor incision is made on the blood vessel and the excess of blood is let out. Cupping therapy (Hijama) is an ancient form of alternative medicine in which a therapist puts special cups on your skin for a few minutes to create suction, the skin is gently drawn upwards by creating a vacuum in a cup over the target area of the skin. Materials and Methods: This study generates knowledge about the analogy between both Kuruthivaangal (Blood Letting) and Cupping therapy by comparison through classical texts and peer reviewed journals. Result: This study reveals the comparison of Kuruthivaangal (Blood Letting) with Cupping therapy preferably would be the raising awareness among practitioners more on technical parts of Blood Letting.