Neurodegenerative disorders (NDs) encompass a range of debilitating conditions characterised by progressive neuronal damage, including Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), and amyotrophic lateral sclerosis (ALS). These disorders significantly impact the quality of life of affected individuals, placing a considerable burden on healthcare systems globally. Despite substantial research, pharmacological treatment remains limited, primarily focusing on symptom management rather than halting or reversing disease progression. This review aims to explore the current state of the pharmacological management of NDs, highlighting established therapies and emerging treatment strategies. This article examines current drug treatments, their mechanisms of action, limitations, and ongoing advancements in therapeutic approaches. Disease-modifying therapies, innovative drug delivery systems aimed at overcoming the blood-brain barrier, repurposing existing drugs, and the role of personalised medicine have been explored. A particular emphasis is placed on promising agents such as monoclonal antibodies targeting amyloid-beta in AD, gene therapies in HD and ALS, and neuroprotective strategies. Additionally, challenges in neurodegenerative drug development, such as heterogeneity in patient responses and the complexity of trial designs, are discussed. Future directions, including the integration of artificial intelligence in drug discovery, multitarget approaches, and the importance of environmental and lifestyle interventions, are proposed as potential solutions to these challenges. This review provides an in-depth understanding of the current landscape of pharmacological therapies for NDs and sheds light on future avenues for more effective treatment strategies.