Myopia has emerged as one of the most rapidly increasing ophthalmic disorders worldwide and is now considered a major public health concern due to its rising prevalence and associated vision-threatening complications. Characterized by excessive axial elongation of the eyeball causing light rays to focus in front of the retina, myopia commonly begins during childhood and often progresses throughout adolescence. According to projections by World Health Organization and epidemiological studies by Brien Holden Vision Institute, nearly 50% of the global population may become myopic by 2050, with approximately 10% developing high myopia. High myopia significantly increases the risk of retinal detachment, myopic macular degeneration, glaucoma, cataract formation, and irreversible visual impairment. The increasing prevalence of myopia is largely attributed to a combination of genetic predisposition and environmental influences such as prolonged near work, reduced outdoor activity, excessive screen exposure, urbanization, and educational pressures. Traditional corrective methods such as single-vision spectacles and standard contact lenses effectively improve visual acuity but fail to address the underlying progression of axial elongation. Consequently, modern ophthalmology has shifted toward interventions aimed at slowing myopia progression rather than merely correcting refractive error. Among currently available evidence-based interventions, orthokeratology, low-dose atropine therapy, and specialized spectacle lenses have emerged as the most widely studied strategies for myopia control. Orthokeratology involves overnight wear of specially designed rigid gas-permeable lenses that temporarily reshape the corneal surface and induce peripheral myopic defocus, thereby slowing axial elongation. Several studies report a 40–60% reduction in axial length progression among pediatric populations using orthokeratology. However, challenges include high cost, lens maintenance, and risk of microbial keratitis. Pharmacological treatment with low-dose atropine has gained widespread popularity following landmark trials such as the ATOM Study and LAMP Study. Low-dose atropine (0.01%, 0.025%, and 0.05%) has demonstrated significant reduction in myopia progression while minimizing adverse effects compared to higher concentrations. However, rebound progression after discontinuation and variable treatment response remain concerns. Recent advancements in spectacle lens design have introduced non-invasive alternatives such as MiYOSMART and Stellest lenses. These lenses utilize peripheral defocus technology and highly aspherical lenslets to slow myopic progression by approximately 40–60%. Their safety profile and ease of use make them attractive for younger children. This review critically compares orthokeratology, atropine, and spectacle lens interventions in terms of efficacy, safety, compliance, cost-effectiveness, adverse effects, long-term outcomes, and patient suitability. It also explores combination therapies, artificial intelligence-assisted monitoring, genetic research, and future personalized treatment strategies. The review concludes that no single intervention is universally superior. Individualized treatment selection based on age, progression rate, lifestyle, refractive status, ocular health, and patient compliance remains essential for optimal long-term myopia management.