Ilaj- bil- Hijāmat (cupping therapy) is one of the commonest classical modes of treatment in Unani System of Medicine and is widely used to manage and prevent various illnesses and ailments supposed to be caused by the predominance of humors, including Waja-ul-mafāsil (arthritis and sciatica). A randomized open controlled clinical trial was conducted to evaluate the efficacy and safety of Hijāmat- bil- shart (wet cupping). The study was conducted on 40 human subjects equally allocated in test and control groups (20 in each). The test group was subjected to the Hijāmat- bil- shart along with pharmacopoeial Unani drugs over a period of 6 weeks while the control group received the drugs only over the same period. The laboratory and radiological investigations were carried out before and after the treatment. Significant improvements were observed in disease specific symptoms e.g. joint pain, joint swelling, joint stiffness, restriction of movement and muscular weakness. In test group the pain level decreased by 62.50%, stiffness by 64.16%, swelling by 52.50%, restriction of movement by 77.50% and muscular weakness by 31.16%. Control group showed decrease in pain by 28.75%, stiffness by 38.33%, swelling by 22.50%, restriction of movement by 24.16% and muscular weakness by 22.50%. No significant difference was observed in laboratory and radiological findings in different groups. The study demonstrated that Hijāmat- bil- shart induced significant reduction in the cardinal symptoms of Waja-ul-mafāsil.