The intrathecal route of administration, which involves the direct delivery of therapeutic agents into the cerebrospinal fluid (CSF) via lumbar or cervical puncture, has gained increasing prominence in the field of healthcare and neurology. This review provides a comprehensive overview of the intrathecal route as a mode of drug delivery, focusing on its applications, advantages, challenges, and safety considerations. Intrathecal administration offers a unique advantage by bypassing the blood-brain barrier, allowing for precise and targeted drug delivery to the central nervous system. This approach has proven effective in managing a variety of conditions, including chronic pain, spasticity, infections, and neoplastic diseases. Furthermore, it has shown promise in the treatment of neurodegenerative disorders, such as amyotrophic lateral sclerosis (ALS) and multiple sclerosis. Despite its potential benefits, intrathecal therapy presents challenges related to its invasive nature, the risk of infection, and the need for specialized equipment and personnel. Careful patient selection and ongoing monitoring are essential to mitigate these risks. In addition, ongoing research is focused on improving drug formulations and delivery techniques to enhance the safety and efficacy of intrathecal therapy1 . This review consolidates key findings from recent studies, clinical trials, and expert opinions, shedding light on the current state of intrathecal administration and its evolving role in medical practice. By exploring the latest advancements and addressing critical considerations, this review aims to provide valuable insights to healthcare professionals, researchers, and clinicians working with intrathecal drug delivery. Key words: Intrathecal therapy, Cerebrospinal fluid (CSF), Drug delivery, Neurological disorders, Central nervous system, Blood-brain barrier.