Background: Sayalān al-Raḥim (Leucorrhoea) is a common gynecological condition characterized by abnormal vaginal discharge, often associated with bacterial vaginosis, candidiasis, and altered vaginal flora. Traditional treatments may not always be effective, necessitating alternative therapeutic approaches. This study aimed to evaluate the efficacy and safety of a Unani formulation in treating Sayalān al-Raḥim (Leucorrhoea) and to assess its impact on various clinical parameters, including Pap smear results, bacterial flora composition, and vaginal pH levels. Methods: A randomized controlled trial with 26 patients in each group (test and control) compared the efficacy of Unani formulation versus standard treatment. Assessments included Pap smear, Gram staining, Nugent scoring, vaginal pH, and yeast cell presence in KOH preparations before and after treatment. Safety parameters like CBC, LFT, and KFT were monitored. Results: In the test group, the percentage of patients with normal Pap smear results increased significantly from 3.85% before treatment to 100% after treatment, while the control group saw an increase from 3.85% to 69.23%. Nugent scoring indicated a substantial shift from bacterial vaginosis to normal flora in the test group, with the proportion of patients with normal flora rising from 38.46% to 73.08% post-treatment. The control group also showed improvement, though less pronounced. Furthermore, before treatment, no participants exhibited normal pH levels. Post-treatment, 100% of the test group and 80.77% of the control group achieved normal pH levels, indicating a significant positive impact of the Unani formulation (Fisher exact test, p = 0.05). The presence of yeast and clue cells significantly decreased in the test group post-treatment (McNemar's test, p < 0.0001), demonstrating the antifungal efficacy of the formulation. All safety parameters, including CBC, LFT, and KFT, remained stable throughout the treatment period, indicating the safety of the test drug. Conclusion: The Unani formulation (safuf) demonstrated superior efficacy in treating Sayalān al-Raḥim, achieving significant improvements in Pap smear results, bacterial flora composition, and vaginal pH levels.