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A Comprehensive Manual on Leech Therapy; The Nature's Surgeons bridges centuries-old healing traditions with modern clinical practice; offering a practical, evidence-based guide to medicinal leech therapy (hirudotherapy). Historical insight from Ayurvedic and Unani traditions through medieval Europe to modern microsurgery and reconstructive medicine. Biochemical depth, illuminating key saliva bioactives like hirudin, apyrase, eglins, and calin, with proven anticoagulant and healing benefits. Clinically focused: protocols covering flap salvage, venous congestion relief, osteoarthritis, chronic ulcers, and post-surgical applications. Safety-first guidance: contraindications, infection risk management (e.g. Aeromonas hydrophila), antibiotic prophylaxis, and patient-monitoring tools. User-ready tools: includes forms for consent, monitoring, supply checklists, and patient leaflets; designed for immediate implementation. This manual is an essential resource for healthcare professionals, integrative practitioners, and researchers seeking safe, effective, and sustainable approaches to leech therapy with clinical confidence.