Paracetamol is a widely used analgesic and antipyretic drug with excellent safety at therapeutic doses. However, conventional oral administration suffers from drawbacks such as hepatic first-pass metabolism, short half-life, and the need for frequent dosing. Transdermal drug delivery systems (TDDS) offer controlled drug release, improved bioavailability, and better patient compliance. Due to the hydrophilic nature and low permeability of paracetamol, various formulation strategies such as the use of permeation enhancers, polymeric matrices, nanocarriers, and physical enhancement techniques have been investigated. This review provides a detailed overview of the physicochemical properties of paracetamol, skin structure, formulation components, preparation methods, evaluation parameters, permeation enhancement approaches, recent advancements, and future perspectives in the development of paracetamol transdermal patches.