The area around this temple was once surrounded by a dense forest of a bushy, thorny suffruticose herb known as 'Kaarai' in tamil, hence earning the name 'Kaarai Kaadu'. Presently, this location is recognized as Thirukaalimedu with the deity being referred to as 'Thirukaaleeshwarar'. It is also identified as 'Indra puri' due to the worship of the celestial god Indra at this site.
The temple has an entrance facing west, and from this entrance, a pathway leads to another gateway with a Gopuram consisting of three tiers. Dwajasthambam, Nandi and Balipeetam are along the path that leads to the gateway that in turn lead to the outer prakaram which facilitates circumambulation. An inner gateway from the outer-prakaram leads to the inner prakaram which surrounds the sanctum. The sannidhi's within the inner prakaram include sannidhis for 'Nalvar', the Celestial God Indra, Bhudhan, Bhairava, Vinayaka, Subramanya, and His consorts Valli, Deivanai, and Gajalakshmi. Ganapathy, Dakshinamurthy, Lingothbhavar, Brahma, and Goddess Durga adorn the walls around the sanctum as 'Goshta Murtha's.
The entrance to the sanctum is flanked by Dwara Vinayaka and Dwara Subramanya. The presiding deity Karai Thirunatheshwar or Sathyanathaswamy is a 'Swayambhu Linga' within the west-facing sanctum. This self-manifested Lingam is characterized by its red soil color, rough texture, and tall, wide circumference. Adjacent to this Linga is the 'Urchava' idol of the female deity, along with sannidhis dedicated to Surya and a Nataraja Sabha.
Indra, the Celestial God, created a sacred water body for the anointment of the deity, which is currently referred to as 'Veppankulam' and suffers from inadequate maintenance. This Shiva temple holds particular importance for individuals born under the 'Mithuna' and 'Kanni' Rasis, as well as for those experiencing challenges related to Mercury in their astrological charts. The significance arises from the belief that Bhudan, the lord of Mercury, has worshipped the deity at this site, leading to the conviction that visiting the temple on Wednesdays and venerating Kaarai Tirunatheswarar can amplify Mercury's beneficial effects in their lives.
The pathikam composed by Thirugyanasambandhar is in 3'rd Tirumurai.