This review discusses the treatment options for leishmaniasis, a neglected tropical disease with three main clinical forms: cutaneous (CL), mucocutaneous (MCL), and visceral (VL). Treatment varies by disease type, with systemic therapy required for MCL and VL, while CL may be managed with localized or oral treatments. The effectiveness of treatments depends on the parasite species, which can differ by region and may have unique clinical presentations and resistance profiles. Due to limited evidence-based guidelines, physicians often rely on case reports or studies rather than randomized controlled trials. Defining a cure is challenging, as parasite death is common but aesthetic outcomes, such as scarring, are unpredictable. Treatment considerations include efficacy, ease of use, safety, and cost. For VL, miltefosine is an effective oral treatment, though it is not approved for children under 12. Liposomal amphotericin B is a safer intravenous option, though more expensive. Pentavalent antimonials are also used but have significant side effects. For MCL, systemic treatment is necessary, and liposomal amphotericin B is effective, though treatment failure is common. For CL, topical treatments are preferred, but systemic options may be needed for severe or complicated cases. Local treatments like cryotherapy and thermotherapy are used, though they may cause side effects. Oral miltefosine is the preferred treatment for CL, but it is not always accessible. The review emphasizes the need for more affordable and effective treatments, particularly for CL, MCL, and VL. It highlights the importance of molecular diagnosis to guide treatment and the challenges of managing leishmaniasis in resource-limited settings. The article also discusses the importance of monitoring for complications, such as secondary bacterial infections and keloid formation, and the role of adjunctive therapies in improving outcomes. Overall, the treatment of leishmaniasis requires a balanced approach considering various factors to ensure effective and safe management of the disease.This review discusses the treatment options for leishmaniasis, a neglected tropical disease with three main clinical forms: cutaneous (CL), mucocutaneous (MCL), and visceral (VL). Treatment varies by disease type, with systemic therapy required for MCL and VL, while CL may be managed with localized or oral treatments. The effectiveness of treatments depends on the parasite species, which can differ by region and may have unique clinical presentations and resistance profiles. Due to limited evidence-based guidelines, physicians often rely on case reports or studies rather than randomized controlled trials. Defining a cure is challenging, as parasite death is common but aesthetic outcomes, such as scarring, are unpredictable. Treatment considerations include efficacy, ease of use, safety, and cost. For VL, miltefosine is an effective oral treatment, though it is not approved for children under 12. Liposomal amphotericin B is a safer intravenous option, though more expensive. Pentavalent antimonials are also used but have significant side effects. For MCL, systemic treatment is necessary, and liposomal amphotericin B is effective, though treatment failure is common. For CL, topical treatments are preferred, but systemic options may be needed for severe or complicated cases. Local treatments like cryotherapy and thermotherapy are used, though they may cause side effects. Oral miltefosine is the preferred treatment for CL, but it is not always accessible. The review emphasizes the need for more affordable and effective treatments, particularly for CL, MCL, and VL. It highlights the importance of molecular diagnosis to guide treatment and the challenges of managing leishmaniasis in resource-limited settings. The article also discusses the importance of monitoring for complications, such as secondary bacterial infections and keloid formation, and the role of adjunctive therapies in improving outcomes. Overall, the treatment of leishmaniasis requires a balanced approach considering various factors to ensure effective and safe management of the disease.