This article, authored by Hayoung Choi, Pamela J. McShane, Stefano Aliberti, and James D. Chalmers, provides an up-to-date review of bronchiectasis management in adults. Bronchiectasis, once considered a rare disease, has seen significant advancements in research and treatment. Randomized clinical trials (RCTs) have confirmed the benefits of airway clearance techniques, inhaled antibiotics, and long-term macrolide therapy. However, the heterogeneity of bronchiectasis remains a major challenge. The authors highlight the identification of phenotypes and endotypes to better understand and treat the disease. The primary goals of therapy are to reduce symptom burden, improve quality of life, minimize exacerbations, and prevent disease progression. The review covers both pharmacological and non-pharmacological treatments aimed at improving mucociliary clearance, reducing airway inflammation, and addressing airway infections. Additionally, it discusses promising new treatments, including novel anti-inflammatory therapies, and provides a critical update on the latest research and RCTs in bronchiectasis management.This article, authored by Hayoung Choi, Pamela J. McShane, Stefano Aliberti, and James D. Chalmers, provides an up-to-date review of bronchiectasis management in adults. Bronchiectasis, once considered a rare disease, has seen significant advancements in research and treatment. Randomized clinical trials (RCTs) have confirmed the benefits of airway clearance techniques, inhaled antibiotics, and long-term macrolide therapy. However, the heterogeneity of bronchiectasis remains a major challenge. The authors highlight the identification of phenotypes and endotypes to better understand and treat the disease. The primary goals of therapy are to reduce symptom burden, improve quality of life, minimize exacerbations, and prevent disease progression. The review covers both pharmacological and non-pharmacological treatments aimed at improving mucociliary clearance, reducing airway inflammation, and addressing airway infections. Additionally, it discusses promising new treatments, including novel anti-inflammatory therapies, and provides a critical update on the latest research and RCTs in bronchiectasis management.