Vayalil founded VPS Healthcare in 2007. The company now has 15 brands, 24 operational hospitals, and over 125 health centers across the Middle East and India. It employs over 15,000 people. In February 2022, VPS announced that it was partnering with surgeon Sultan al Maskari to establish the Maskari Burjeel Orthopedic Centre at the Burjeel Hospital in Muscat, Oman. Vayalil had a net worth of $1.3 billion in 2020, according to Forbes. He is also vice-chairman of Amanat Holdings.