It is significant to the Hindu sect of Saivism as one of the temples associated with the nine planet elements, the Navagraha Stalas, and specifically Rahu.

[1] Many serpents, including Adishesha, Takshaka and Karkotaka, worshipped Shiva at this place, leading to the name "Tirunageswaram".

As per Hindu legend, the king of snakes, Adisesha did penance at this place, called Senbaranya Kshetram on account of the presence of large number of Senbaga trees.

To obtain deliverance from the sage's curse, it is said that Indra worshipped Giri-Gujambigai with a scented material termed Punugu for 45 days.

The kumbha is believed to have been displaced by a pralaya (dissolution of the universe) and ultimately came to rest at the spot where the town of Kumbakonam now stands.

The Vinayaka shrine, bali pitha, Nandikeshwara hall and flag post are located in the eastern entrance.

The temple tank is called Sula Theertham, a dip in which, is believed to clear sins committed by human beings.

In the path way to main shrine, there are art works depicting Veda nayakas, king Sambumali and penance pose of Ambal.

The temple rituals are performed six times a day; Ushathkalam at 6:00 a.m., Kalasanthi at 9:00 a.m., Uchikalam at 1:00 p.m., Sayarakshai at 5:00 p.m., Irandamkalam at 7:00 p.m. and Ardha Jamam at 9:00 p.m.

Each ritual comprises four steps: abhisheka (sacred bath), alangaram (decoration), neivethanam (food offering) and deepa aradanai (waving of lamps) for both Annamalaiyar and Unnamulai Amman.

Kandasashti festival is celebrated for six during October or November every year when Murugan, the son of Shiva, symbolically kills the demon Surapadma.

[11] The ablution of the image of Rahu during Rahukaalam with milk turning to blue colour in this temple is considered to be a miracle and attracts devotees from distant places.

[12] As per Hindu belief, people troubled by Sarpa-dosha or Malefic effects Rahu-Kethu seek a relief by offering prayers in a single day to Kudanthai or Kumbakonam Nageshwarar in the morning, Thirunageshwaram Naganathar at the noon, Thirupamburam Pambureswarar in the evening and Nagoor Nageshwarar or Naganathar temple at night.

[2][13] Tirugnana Sambandar, a 7th-century Tamil Saivite poet, venerated Naganathar in ten verses in Tevaram, compiled as the First Tirumurai.