Femoroacetabular impingement syndrome (FAIS) has rapidly emerged from a little-recognized surgical complication to a major focus of orthopaedic research. Driven by advances in hip imaging and minimally invasive techniques, debate continues over the optimal management strategy: structured physiotherapy, intra-articular injections, open surgical dislocation, or hip arthroscopy. Each approach carries distinct advantages, risks, and implications for recovery, return to sport, and long-term joint preservation. In recent years, high-quality randomized trials and meta-analyses have begun to reshape clinical decision-making, yet important gaps remain regarding durability of outcomes and the balance between non-operative and surgical interventions. This comprehensive review synthesizes the latest evidence, comparing functional outcomes, radiological changes, and patient-reported measures across treatment modalities. The findings illuminate not only the evolution of FAIS care but also the pressing questions that will define its future.