Alzheimer’s disease (AD) is a progressive neurodegenerative disorder and the most common cause of dementia. It is characterized by progressive impairment of memory, cognition, behavior and functional ability. The pathological features traditionally associated with AD include extracellular amyloid-? (A?) plaques, intracellular hyperphosphorylated tau neurofibrillary tangles, synaptic dysfunction, neuronal loss, neuroinflammation and oxidative stress. Management has historically focused mainly on symptomatic treatment with acetylcholinesterase inhibitors and the N-methyl-D-aspartate receptor antagonist memantine. However, the therapeutic landscape has changed substantially with the development of disease-modifying therapies directed against A? pathology. Lecanemab and donanemab have demonstrated statistically significant slowing of cognitive and functional decline in patients with early symptomatic AD and confirmed amyloid pathology. These advances have also highlighted the importance of biomarker-based diagnosis, appropriate patient selection and monitoring for amyloid-related imaging abnormalities (ARIA). Blood-based biomarkers, including phosphorylated tau and amyloid-related markers, are increasingly being investigated as accessible diagnostic and monitoring tools. Beyond amyloid, therapeutic research is exploring tau pathology, neuroinflammation, synaptic dysfunction, mitochondrial impairment, vascular mechanisms, metabolic abnormalities and genetic targets. Non-pharmacological interventions, including physical activity, cognitive stimulation, sleep optimization, dietary approaches and social engagement, remain important components of comprehensive care. This review summarizes the pathophysiology, diagnosis, conventional pharmacotherapy, recent disease-modifying treatments, emerging therapeutic approaches, non-pharmacological management, challenges and future perspectives in AD. The transition from symptomatic management toward biologically targeted treatment represents an important development in AD therapeutics, although questions concerning long-term benefit, safety, cost, accessibility and implementation remain