Background <p>Zika virus (ZIKV), known for its alarming health consequences, is primarily transmitted by infected <i>Aedes</i> spp. mosquitoes but can also spread through sexual contact and from mother to child during pregnancy. While most infections are mild or asymptomatic, ZIKV has been linked to severe neurological disorders, such as Guillain–Barré syndrome (GBS) in adults and congenital Zika syndrome (CZS) in infants. While the substantial economic burden and the range of these disorders have been described, the potential long-term effects and the impact on quality of life (QoL) remain inadequately understood, presenting challenges for both public health and clinical care.</p> Main body <p>This narrative review describes the broader spectrum of neurological complications associated with ZIKV infection and explores their impact on the QoL of patients and caregivers, aiming to deepen the public and clinical understanding of the topic, which is crucial for developing effective prevention and treatment strategies. Beyond the established links to GBS and CZS, ZIKV has been associated with other neurological complications, such as encephalitis and myelitis, highlighting the complex clinical course of the disease. These neurological outcomes can lead to lifelong disabilities, profoundly affecting patients’ and caregivers’ QoL. Mothers of children with CZS may experience heightened anxiety, depression, and overall reduced QoL, while many individuals with GBS struggle to regain the QoL they had pre-illness.</p> Conclusions <p>The limited availability of high-quality data, primarily relying on case reports, highlights the need for more comprehensive research to establish clear causal links and better understand the long-term consequences of ZIKV-related neurological complications. Prioritizing research on long-term effects, management, and prevention strategies is crucial to improving patient outcomes and guiding future clinical care.</p>