Axial spondyloarthritis (axSpA) is a chronic inflammatory disease primarily affecting the axial skeleton, leading to significant disability if left untreated. Over the past few decades, there have been significant advancements in the treatment options for axSpA, driven by a deeper understanding of its pathophysiology and the development of novel therapeutic agents. This review summarizes the state-of-the-art treatment strategies for axSpA, focusing on pharmacologic therapies, non-pharmacologic interventions, and emerging biological agents. The review also highlights the importance of a multidisciplinary approach in managing the disease. Current challenges, such as treatment access, patient compliance, and the long-term effects of treatment regimens, are also discussed. The evolving landscape of axSpA treatment suggests a promising future for patients, with enhanced therapeutic outcomes and quality of life.