Molar–incisor pattern periodontitis (MIPP) is a severe form of periodontal disease characterized by rapid attachment loss and bone destruction affecting the molars and incisors. Formerly referred to as aggressive periodontitis, the terminology for this condition was revised after the 2017 workshop on the classification of periodontal and peri-implant diseases and conditions. Despite the modification in nomenclature, the treatment strategies for MIPP remain a critical area of investigation. The core principles of MIPP treatment involve controlling local and systemic risk factors, managing inflammation, and arresting disease progression. Traditional non-surgical periodontal therapy, including scaling and root planing, is commonly employed as an initial step together with the prescription of antibiotics. Surgical intervention may be necessary to address the severe attachment loss. Surgical techniques like resective and regenerative procedures can aid in achieving periodontal health and improving esthetic outcomes. This review article aims to provide an overview of the current understanding and advancements in the treatment modalities of MIPP. Through an extensive analysis of the existing literature, we discuss various modern therapeutic approaches that have been explored for managing this challenging periodontal condition. © 2023 by the authors.