Alzheimer's disease (AD) is the most common form of dementia, affecting over 47 million people globally, with projections of 130 million by 2050. It is a multi-factorial neurodegenerative disorder influenced by genetic, lifestyle, and comorbidity factors. Current treatments include acetylcholinesterase inhibitors (AChEIs) like donepezil, galantamine, and rivastigmine, and NMDA receptor modulators like memantine, which provide symptomatic relief but limited disease modification. Anti-amyloid monoclonal antibodies (MABs), such as aducanumab, lecanemab, and donanemab, target amyloid-β (Aβ) plaques, but clinical trials have shown mixed results, with lecanemab being the only MAB approved as of April 2024. Despite their potential, MABs face challenges including high costs, side effects, and limited efficacy in some patients. The amyloid hypothesis, which posits that Aβ accumulation drives AD, is under scrutiny due to inconsistent clinical trial outcomes and the presence of amyloid-negative AD cases. Other hypotheses, including cholinergic, glutamate, and vascular pathways, are also being explored. Comorbidities like hypertension, diabetes, and depression are known risk factors for AD, and their management is crucial. New drug targets, including neuroinflammation and mitochondrial dysfunction, are under investigation. The review emphasizes the need for further research into alternative therapies and the importance of early intervention to improve outcomes for patients and their families.Alzheimer's disease (AD) is the most common form of dementia, affecting over 47 million people globally, with projections of 130 million by 2050. It is a multi-factorial neurodegenerative disorder influenced by genetic, lifestyle, and comorbidity factors. Current treatments include acetylcholinesterase inhibitors (AChEIs) like donepezil, galantamine, and rivastigmine, and NMDA receptor modulators like memantine, which provide symptomatic relief but limited disease modification. Anti-amyloid monoclonal antibodies (MABs), such as aducanumab, lecanemab, and donanemab, target amyloid-β (Aβ) plaques, but clinical trials have shown mixed results, with lecanemab being the only MAB approved as of April 2024. Despite their potential, MABs face challenges including high costs, side effects, and limited efficacy in some patients. The amyloid hypothesis, which posits that Aβ accumulation drives AD, is under scrutiny due to inconsistent clinical trial outcomes and the presence of amyloid-negative AD cases. Other hypotheses, including cholinergic, glutamate, and vascular pathways, are also being explored. Comorbidities like hypertension, diabetes, and depression are known risk factors for AD, and their management is crucial. New drug targets, including neuroinflammation and mitochondrial dysfunction, are under investigation. The review emphasizes the need for further research into alternative therapies and the importance of early intervention to improve outcomes for patients and their families.