Chronic pruritus is defined as an unpleasant sensation on the skin that causes scratching and lasts more than six weeks. This symptom may be a manifestation of a cutaneous or systemic disease and it jeopardizes the patients' quality of life, constantly altering their sleep and daily activities. The pathophysiology is complex and it includes multiple mediators and their respective receptors which, through different signaling pathways, carry information through type C nerve fibers towards the thalamus; from where it is distributed to various areas of the cerebral cortex. The understanding of these mechanisms has made it possible to identify potential therapeutic targets and the development of molecules that are increasingly more effective and safer for patients. The present review aims to give a vision of the diagnostic and therapeutic handling of patients with chronic pruritus.