A lifelong gluten-free diet (GFD) is the only treatment for celiac disease (CD) and other gluten-related disorders. However, strict adherence to the GFD is challenging due to social isolation, gluten contamination risks, high costs, poor quality, and the taste of gluten-free products. While effective in achieving mucosal healing, the GFD may lead to nutrient deficiencies over time. To address these issues, new gluten-free wheat flours have been developed to create products similar to gluten-containing ones. Monitoring adherence to the GFD is crucial, as it helps prevent dietary transgressions. Methods such as clinical assessments, questionnaires, serology, duodenal biopsies, and detection of gluten immunogenic peptides (GIPs) are used, but none are entirely satisfactory. Alternative therapies are needed to improve treatment efficacy and quality of life for CD patients. The aim of this review is to explore current knowledge of the GFD and its future perspectives, focusing on technology advancements, follow-up strategies, and insights into a rapidly changing future. CD is an autoimmune disease caused by genetic and environmental factors, leading to intestinal and extraintestinal manifestations. Gluten-containing grains include wheat, barley, rye, and spelt, while oats are naturally gluten-free but can be contaminated. CD prevalence is around 1%, with some regions showing higher rates. Non-celiac gluten sensitivity (NCGS) is a condition where patients experience symptoms after gluten consumption without IgA anti-tTG or IgE against wheat. A GFD is the cornerstone of CD management, but not mandatory for NCGS. Adherence to the GFD is challenging due to social, economic, and psychological factors. Monitoring adherence is essential to prevent transgressions, and methods such as GIP detection and miRNA analysis show promise. Gluten contamination remains a significant issue, with both labeled and naturally gluten-free products at risk. Oats are a controversial topic due to potential cross-contamination. Nutritional imbalances are common in GFDs, with deficiencies in vitamins, minerals, and fibre. Psychosocial quality of life is significantly affected by the strict nature of the GFD. New ingredients and technologies are being developed to improve the quality and nutritional value of gluten-free products. Future perspectives include the use of novel gluten-free flours, alternative pseudocereals, and advanced monitoring techniques to enhance the effectiveness and acceptance of the GFD.A lifelong gluten-free diet (GFD) is the only treatment for celiac disease (CD) and other gluten-related disorders. However, strict adherence to the GFD is challenging due to social isolation, gluten contamination risks, high costs, poor quality, and the taste of gluten-free products. While effective in achieving mucosal healing, the GFD may lead to nutrient deficiencies over time. To address these issues, new gluten-free wheat flours have been developed to create products similar to gluten-containing ones. Monitoring adherence to the GFD is crucial, as it helps prevent dietary transgressions. Methods such as clinical assessments, questionnaires, serology, duodenal biopsies, and detection of gluten immunogenic peptides (GIPs) are used, but none are entirely satisfactory. Alternative therapies are needed to improve treatment efficacy and quality of life for CD patients. The aim of this review is to explore current knowledge of the GFD and its future perspectives, focusing on technology advancements, follow-up strategies, and insights into a rapidly changing future. CD is an autoimmune disease caused by genetic and environmental factors, leading to intestinal and extraintestinal manifestations. Gluten-containing grains include wheat, barley, rye, and spelt, while oats are naturally gluten-free but can be contaminated. CD prevalence is around 1%, with some regions showing higher rates. Non-celiac gluten sensitivity (NCGS) is a condition where patients experience symptoms after gluten consumption without IgA anti-tTG or IgE against wheat. A GFD is the cornerstone of CD management, but not mandatory for NCGS. Adherence to the GFD is challenging due to social, economic, and psychological factors. Monitoring adherence is essential to prevent transgressions, and methods such as GIP detection and miRNA analysis show promise. Gluten contamination remains a significant issue, with both labeled and naturally gluten-free products at risk. Oats are a controversial topic due to potential cross-contamination. Nutritional imbalances are common in GFDs, with deficiencies in vitamins, minerals, and fibre. Psychosocial quality of life is significantly affected by the strict nature of the GFD. New ingredients and technologies are being developed to improve the quality and nutritional value of gluten-free products. Future perspectives include the use of novel gluten-free flours, alternative pseudocereals, and advanced monitoring techniques to enhance the effectiveness and acceptance of the GFD.