Vitiligo is an acquired, chronic depigmenting disorder characterized by the gradual loss of functional melanocytes in the epidermis, leading to well-demarcated amelanotic macules and patches. Its onset may occur at any age, with an average age of 30 years, and is influenced by complex interactions between genetic susceptibility, intrinsic melanocyte defects, oxidative stress, and autoimmune responses. The disease displays considerable clinical heterogeneity, with segmental, non-segmental, mixed, and rare variants such as follicular, trichrome, and vitiligo ponctué presentations. Histopathologically, lesions typically show an absence of melanocytes, with occasional lichenoid inflammation at the margins. Beyond cutaneous changes, vitiligo has a strong association with autoimmune comorbidities, including thyroid disorders, alopecia areata, and type 1 diabetes mellitus, alongside significant psychosocial implications. Current topical therapies form the cornerstone of management, with corticosteroids, calcineurin inhibitors, and vitamin D analogs widely employed either as monotherapy or in combination with phototherapy. Psoralen-based photochemotherapy, phenylalanine, and newer approaches such as topical methotrexate, mycophenolate mofetil, JAK inhibitors (e.g., ruxolitinib), and growth factor-based treatments have expanded the therapeutic armamentarium. Adjunctive strategies like antioxidants, prostaglandin analogs, piperine, and camouflage play supportive roles. This review consolidates the pathogenesis, clinical spectrum, histopathology, comorbidities, and therapeutic advances in vitiligo, emphasizing the need for a holistic, individualized approach to management to address both physical and psychosocial impacts.