The presiding deity is revered in the seventh century Tamil Saiva canonical work, the Tevaram, written by Tamil saint poets known as the nayanmars and classified as Paadal Petra Sthalam. Sambandar has revered the Agatheeswarar in ten verses classified in second Tirumurai.
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 six times a day; Ushathkalam at 5:30 a.m., Kalasanthi at 8:00 a.m., Uchikalam at 10:00 a.m., Sayarakshai at 5:00 p.m., Irandamkalam at 7:00 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 Agastheeswarar and Amman.
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 worshippers 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.
The twin festivals celebrated during the full moon days of Tamil month Adi (July – August) and Thai (January – February) attract large number of pilgrims from whole of Tamil Nadu. Pilgrims take a holy dip in the seashore round the year and the holy dip is considered similar to the worship practises at Rameswaram.
