Aim: The aim of this review was to highlight the ongoing challenge of medication-related osteonecrosis of the jaw (MRONJ) in everyday clinical practice. Materials and Methods: This review was conducted following a structured narrative approach, utilizing PubMed as the primary research database. The following keywords and their combinations with Boolean operators (AND, OR) were used: MRONJ, osteonecrosis, bisphosphonates, bone density conservation agents, denosumab. The literature search spanned publications from 2003 to April 2025, corresponding to the first description of bisphosphonate-related osteonecrosis of the jaw by Marx and subsequent evolution of the diagnostic and therapeutic concepts.The final set of 32 articles were reviewed and synthesized narratively. Conclusions: Management strategies are examined across disease stages, from conservative measures and pharmacologic interventions to surgical resection and reconstruction. Emerging therapies, including teriparatide, hyperbaric oxygen, platelet-rich preparations, and cryosurgery, show promise as adjunctive treatments. Prevention remains paramount, emphasizing pre-treatment dental evaluation, patient education, and interprofessional collaboration.