This is a small temple and has no flag post (kodimaram) and tower.  The roof tower (Vimana) in the sanctum sanctorum has paintings of Lord Dakshinamurthy and Lord Krishna. 

Lord Gautameswara is praised by the devotees as Vaid (doctor) for curing the prolonged and serious illnesses of His devotees.  They offer abishek, vastras and also a mixture of dry ginger, pepper and thippili as nivedhana and consume it as Prasad for remedy from serious diseases.

The structure of the temple is such that the shrine of Mother Krupambika is in the Mandap just opposite the Shrine of the Lord facilitating simultaneous darshan of both.  Sage Gautama graces in a sitting form in the temple. Lord Sabeswara appears furious in a shrine.  Lord Vinayaka is installed by His side to cool him down.  There is a separate shrine for Lord Bhairava.

On Shivarathri day Lord graces with Mother Krupambika sitting on the Vrushab, the bull vehicle of the Lord – Nandhi.  This worship is considered very blessingful.   The place on the northern bank of River Palaru was once dense with Karai trees.  Hence, the name Karaimaraikadu which in course of time shrunk as Karai.

Besides this temple, on Shivarathri day, devotees also visit simultaneously other nearby Shiva temples at Mel Visharam, Veppur, Pudupadi, Kudimanallur, Vannivedu and Avarakkarai.  To facilitate darshan to the devotees, all the temples are kept open during the whole night.