The role of stack height in running footwear has been critically analyzed with an emphasis on its biomechanical and performance-related impacts. It has been established that stack height influences key factors such as ground reaction forces, foot strike patterns, and running economy. Research has highlighted significant variability in how runners respond to different stack heights, complicating the optimization of footwear design. Various studies have demonstrated both the benefits and drawbacks of high and low stack heights, with ongoing debates about their effects on performance and injury prevention. A major gap in the current literature pertains to the lack of a consensus on how stack height should be adapted to individual biomechanical profiles. Recent developments in footwear engineering, such as carbon plates and advanced foam materials, have further complicated the understanding of stack height optimization. Hypothetical solutions have been proposed, including personalized footwear solutions that tailor stack height to a runner’s biomechanics. This method shows promise in bridging the gap by offering individualized footwear designs based on detailed biomechanical profiling. It is suggested that dynamic stack height adjustment technologies and machine learning-based data collection could further improve footwear customization. Moreover, gender-specific responses to stack height require further investigation to develop more precise footwear designs. Future research is recommended to explore the long-term effects of personalized stack height solutions, the integration of smart materials, and the role of psychological factors in footwear design. Such advancements could lead to more effective performance enhancements and injury prevention strategies for runners.