She had previously been cast and then replaced in Mani Ratnam's Kaatru Veliyidai (2017), while she opted out Vijay Chander's Sketch (2017). For Sai Pallavi, it became her first Tamil language film following a series of projects which she dropped out of, she was replaced in or was shelved. After securing the actress's dates to shoot the film, Vijay finalised the technical crew to include his regular collaborators such as cinematographer Nirav Shah and editor Anthony. He had chosen to cast Sai Pallavi, after another project for Pramod Films, which would have been a Tamil remake of the Malayalam film Charlie (2015) with Madhavan, was suddenly shelved. Vijay announced that he would be working on a film with her for Lyca Productions and that he would direct a script he had written 'three and a half years ago'. She went onto win her first Filmfare Award for Best Actress - Telugu. Her performance in the film is regarded as one of the '100 Greatest Performances of the Decade' by Film Companion. The year 2017 marked her debut in Telugu with Sekhar Kammula's Fidaa, in the role of Bhanumathi, a feisty village girl from Telangana. As an established actress (2017–present) She portrayed Anjali, a young wife who must deal with her husband's extreme anger issues, earning a nomination for Filmfare Award for Best Actress – Malayalam. Then she took a month break from her studies to act in her second Malayalam film, Kali, which released in March 2016. For that she was the first and director's strong choice of the female lead but she denied the film offer due to pursue her medical studies in Georgia. He confirmed that he would shortly begin work on a project titled Madras with Karthi in the lead role. Ranjith to direct a film for their production house after they had bought and distributed the director's successful previous venture, Attakathi (2012). She went on to win several 'Best Female Debut' awards that year, including the Filmfare Award for Best Female Debut. She shot the film over the holidays and, after the shooting finished, returned to her studies. In 2014, while she was studying in Tbilisi, Georgia, film-director Alphonse Puthren offered her the role of Malar in his film Premam.

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