Staphylococcus aureus (S. aureus) is a significant pathogen in human diseases, particularly in hospitalized patients, where it can cause severe infections despite antibiotic therapy. The increasing prevalence of methicillin-resistant S. aureus (MRSA) strains, often multiresistant, has made prevention of staphylococcal infections more critical. Nasal carriage of S. aureus plays a key role in its epidemiology and pathogenesis. The review discusses the epidemiology of nasal carriage, the risks associated with it, and the need for further studies to develop optimal preventive strategies. The ecological niche of S. aureus is primarily the anterior nares, where it can be isolated consistently. Carriage patterns can be categorized into persistent carriers (20%), intermittent carriers (60%), and noncarriers (20%). Persistent carriage is more common in children and is associated with a protective effect against other strains during hospitalization. The prevalence and incidence of nasal carriage vary across populations, with a mean carriage rate of 37.2% in the general population. Higher carriage rates are observed in specific subgroups, such as patients with insulin-dependent diabetes mellitus, those on hemodialysis, intravenous drug addicts, and HIV-positive individuals. The molecular basis of nasal carriage involves the interaction of S. aureus surface components with host cell membranes. Factors influencing carriage include age, genetic background, and immune response. S. aureus adheres to various epithelial cells, including airway epithelium, bovine mammary gland epithelium, endothelium, and mesothelium, through specific and nonspecific mechanisms. Molecular typing techniques, such as phage typing and DNA typing, are used to monitor the population characteristics and dynamics of S. aureus strains. Carriage of S. aureus is a risk factor for various infections, including surgical wound infections, hemodialysis infections, CAPD infections, HIV-related infections, intravascular device-associated bacteremia, and Wegener's granulomatosis. MRSA carriage poses an even greater risk, with studies suggesting that it is associated with higher infection rates compared to methicillin-susceptible S. aureus (MSSA). The pathogenesis of endogenous infections involves the spread of S. aureus from the nose to other body sites, particularly in immunocompromised individuals. Elimination strategies for nasal carriage include local application of antibiotics or disinfectants, systemic antibiotics, and bacterial interference. Mupirocin has shown good efficacy in eliminating nasal carriage, but its use should be restricted to selected groups and short courses to prevent the development of resistance. Overall, the review highlights the importance of understanding the epidemiology and pathogenesis of nasal carriage to develop effective preventive strategies against staphylococcal infections.Staphylococcus aureus (S. aureus) is a significant pathogen in human diseases, particularly in hospitalized patients, where it can cause severe infections despite antibiotic therapy. The increasing prevalence of methicillin-resistant S. aureus (MRSA) strains, often multiresistant, has made prevention of staphylococcal infections more critical. Nasal carriage of S. aureus plays a key role in its epidemiology and pathogenesis. The review discusses the epidemiology of nasal carriage, the risks associated with it, and the need for further studies to develop optimal preventive strategies. The ecological niche of S. aureus is primarily the anterior nares, where it can be isolated consistently. Carriage patterns can be categorized into persistent carriers (20%), intermittent carriers (60%), and noncarriers (20%). Persistent carriage is more common in children and is associated with a protective effect against other strains during hospitalization. The prevalence and incidence of nasal carriage vary across populations, with a mean carriage rate of 37.2% in the general population. Higher carriage rates are observed in specific subgroups, such as patients with insulin-dependent diabetes mellitus, those on hemodialysis, intravenous drug addicts, and HIV-positive individuals. The molecular basis of nasal carriage involves the interaction of S. aureus surface components with host cell membranes. Factors influencing carriage include age, genetic background, and immune response. S. aureus adheres to various epithelial cells, including airway epithelium, bovine mammary gland epithelium, endothelium, and mesothelium, through specific and nonspecific mechanisms. Molecular typing techniques, such as phage typing and DNA typing, are used to monitor the population characteristics and dynamics of S. aureus strains. Carriage of S. aureus is a risk factor for various infections, including surgical wound infections, hemodialysis infections, CAPD infections, HIV-related infections, intravascular device-associated bacteremia, and Wegener's granulomatosis. MRSA carriage poses an even greater risk, with studies suggesting that it is associated with higher infection rates compared to methicillin-susceptible S. aureus (MSSA). The pathogenesis of endogenous infections involves the spread of S. aureus from the nose to other body sites, particularly in immunocompromised individuals. Elimination strategies for nasal carriage include local application of antibiotics or disinfectants, systemic antibiotics, and bacterial interference. Mupirocin has shown good efficacy in eliminating nasal carriage, but its use should be restricted to selected groups and short courses to prevent the development of resistance. Overall, the review highlights the importance of understanding the epidemiology and pathogenesis of nasal carriage to develop effective preventive strategies against staphylococcal infections.