Adult idiopathic inflammatory myopathies (IIMs) are rare autoimmune disorders affecting multiple organs, making diagnosis and treatment challenging. Current management relies on immunosuppressants like corticosteroids, methotrexate, azathioprine, mycophenolate mofetil, rituximab, and intravenous immunoglobulin, though treatment responses vary across patients and subtypes. Despite substantial challenges in clinical research, such as patient recruitment, misdiagnoses from overlapping symptoms with other conditions, and inconsistencies in disease classification, the growing number of myositis-specific clinical trials provides optimism. Progress in targeted therapies has the potential to refine treatment approaches, support the development of more standardized, evidence-based guidelines, and ultimately enhance patient outcomes. In this paper, we aim to provide a review of the current therapeutic options based on IIM subtypes.