The temple finds mention in Tevaram, the 7th century 12 volume Saiva canonical work by Tamil saints, namely Appar, Sundarar and Campantar. It is one of the shrines of the 275 Paadal Petra Sthalams glorified in the Saiva canon. The temple priests perform the puja (rituals) during festivals and on a daily basis. Like other Shiva temples of Tamil Nadu, the priests belong to the Shaiva community, a Brahmin sub-caste.
The temple rituals are performed four times a day; Ushathkalam at 6:30 a.m., Kalasanthi at 8:00 a.m., Uchikalam at 12:00 a.m., Sayarakshai at 5:00 p.m., and Ardha Jamam at 8:00 p.m. Each ritual comprises four steps: abhisheka (sacred bath), alangaram (decoration), naivethanam (food offering) and deepa aradanai (waving of lamps) for both Manikandeswarar and Karunai Nayagi.
The worship is held amidst music with nagaswaram (pipe instrument) and tavil (percussion instrument), religious instructions in the Vedas (sacred texts) read by priests and prostration by worshipers in front of the temple mast. There are weekly rituals like somavaram (Monday) and sukravaram (Friday), fortnightly rituals like pradosham and monthly festivals like amavasai (new moon day), kiruthigai, pournami (full moon day) and sathurthi. Mahashivaratri during February - March and Thiruvadihari during December are the major festivals celebrated in the temple.
Every year in the month of Maasi (Feb-Mar), on Maga nakshatra (Maga star), the Theerthavari festival is celebrated. The other festivals in the temple are Aadi Pooram, Aaani Thirumanjanam and Marghazi Thiruvathirai. Like Vishnu temples, Garudaseva festival is celebrated in the temple.