This review article discusses the therapeutic evolution in HR+/HER2- breast cancer, focusing on the transition from targeted therapy to endocrine therapy. HR+/HER2- breast cancer is the most common subtype, accounting for 74% of all cases. Current treatment strategies include targeted therapy, endocrine therapy, genomic immunotherapy, and traditional methods such as surgical resection and radiotherapy. The article summarizes the current epidemiology of HR+/HER2- breast cancer, introduces its classification and common treatment methods, and discusses the mechanisms of action of various drugs, including targeted therapy and endocrine hormone therapy drugs, as well as their potential synergistic effects. It also includes clinical trials of these drugs that have been completed or are still in progress. The article highlights the role of CDK4/6 inhibitors, PI3K inhibitors, PARP inhibitors, and Proteolysis-targeting chimeras in targeted therapy, and the use of aromatase inhibitors, Selective Estrogen Receptor Degraders, and Complete estrogen receptor antagonists in endocrine therapy. It discusses the mechanisms of action of these drugs, their clinical trials, and their potential for improving patient outcomes. The article also reviews the results of various clinical trials, including the TRINITI-1, MONALEESA-2, and PALOMA-2 trials, which have demonstrated the efficacy and safety of these drugs in treating HR+/HER2- breast cancer. The article concludes with a discussion of the future directions in the treatment of HR+/HER2- breast cancer, emphasizing the need for further research and development of new therapeutic agents.This review article discusses the therapeutic evolution in HR+/HER2- breast cancer, focusing on the transition from targeted therapy to endocrine therapy. HR+/HER2- breast cancer is the most common subtype, accounting for 74% of all cases. Current treatment strategies include targeted therapy, endocrine therapy, genomic immunotherapy, and traditional methods such as surgical resection and radiotherapy. The article summarizes the current epidemiology of HR+/HER2- breast cancer, introduces its classification and common treatment methods, and discusses the mechanisms of action of various drugs, including targeted therapy and endocrine hormone therapy drugs, as well as their potential synergistic effects. It also includes clinical trials of these drugs that have been completed or are still in progress. The article highlights the role of CDK4/6 inhibitors, PI3K inhibitors, PARP inhibitors, and Proteolysis-targeting chimeras in targeted therapy, and the use of aromatase inhibitors, Selective Estrogen Receptor Degraders, and Complete estrogen receptor antagonists in endocrine therapy. It discusses the mechanisms of action of these drugs, their clinical trials, and their potential for improving patient outcomes. The article also reviews the results of various clinical trials, including the TRINITI-1, MONALEESA-2, and PALOMA-2 trials, which have demonstrated the efficacy and safety of these drugs in treating HR+/HER2- breast cancer. The article concludes with a discussion of the future directions in the treatment of HR+/HER2- breast cancer, emphasizing the need for further research and development of new therapeutic agents.