Adolescent idiopathic scoliosis (AIS) is the most common spinal deformity in adolescents, affecting individuals aged 10–16, with a multifactorial etiology involving genetic, hormonal, and biomechanical influences. This comprehensive literature review included 112 studies from journal conception to February 2025, retrieved from PubMed, Ovid MEDLINE, Scopus, and the Cochrane Library, focusing on epidemiology, pathophysiology, and treatment outcomes. AIS predominantly affects females, with a sex ratio increasing up to 7:1 in severe cases (>40° curves), and with right thoracic curves being the most common pattern. While bracing effectively prevents curve progression in moderate cases, spinal fusion remains the gold standard for severe deformities, ensuring long-term correction and preventing progression, despite a reduction in flexibility. Most adolescents return to full activities within a year postoperatively, with a low incidence of complications, including neurologic injury (~0.2%), infection (1%–5%), and pseudarthrosis (~1%). Future research will focus on optimizing non-fusion therapies, enhancing screening strategies, and integrating personalized medicine to improve patient outcomes and quality of life.