Sai Pallavi was born on 9 May 1992 in Coimbatore, Tamil Nadu, into a Badaga family whose ancestral home is Kotagiri in the Nilgiris. Her father, Senthamarai Kannan, was a Central Excise officer and former footballer. Her mother, Radha Kannan, is a dancer. Her younger sister, Pooja Kannan, is also an actress.
She studied at Avila Convent School, Coimbatore, and then studied medicine at Tbilisi State Medical University in Georgia, graduating in 2016. In August 2020 she passed India's Foreign Medical Graduate Examination (FMGE), but she chose acting over medical practice. She speaks Badaga, Tamil, English, Malayalam, Telugu, Hindi and Georgian.
As a child she appeared in small, uncredited roles in films such as Kasthuri Maan (2005) and Dhaam Dhoom (2008). She took part in Vijay TV's dance show Ungalil Yaar Adutha Prabhu Deva (2008) and was a finalist on Dhee Ultimate Dance Show (2009).
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