The present study was carried out as a randomised standard control adjuvant clinical trial, to evaluate the, add on effect of Majoon-e-Sarakhs with Levothyroxine in Primary Hypothyroidism (Qillat-e-Ifraz-e-Darqiyya Ibtidai). There was no statistically significant difference in baseline characteristics of patients in test versus control group. Samples are matched with age and gender (p=0.110). In this study prevalence of hypothyroidism; females: males are 19:1. The study effects on primary outcomes (TSH, FT3, FT4) and secondary outcome (weight gain, hair fall, cold intolerance, lethargy, constipation) were found significantly reduced in both groups (p<0.001). The results were assessed statistically using two tailed student t test, paired proportion test and Fischer exact test, Kruskall-Wallis with post Dunn’s multiple comparisons tests for intergroup comparisons,. Safety parameters assessment showed that they remained in the normal range in both the groups throughout the treatment. There is no any adverse event or reaction observed or reported during the study either in adjuvant or control group. The study was conducted on 100 patients, which might limit the generalisations of the inferences; however it still suggests the effective role of Majoon-e-Sarakhs in hypothyroidism. Further research is needed in large sample, multiple groups, multiple centres, and special population groups of elderly, children and pregnant women, etc. to bring up this simple Unani compound formulation into the domain of rigorous evidence based medicine.